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Kohlhas L, Studer M, Rutten-Jacobs L, Reigner SM, Sander A, Yap HK, Vondrak K, Coccia PA, Cano F, Schmitt CP, Warady BA, Schaefer F. Real-world evidence on the dosing and safety of C.E.R.A. in pediatric dialysis patients: findings from the International Pediatric Dialysis Network registries. Pediatr Nephrol 2024; 39:807-818. [PMID: 37566114 PMCID: PMC10817843 DOI: 10.1007/s00467-023-05977-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 04/05/2023] [Accepted: 04/05/2023] [Indexed: 08/12/2023]
Abstract
BACKGROUND This retrospective real-world study used data from two registries, International Pediatric Peritoneal Dialysis Network (IPPN) and International Pediatric Hemodialysis Network (IPHN), to characterize the efficacy and safety of continuous erythropoietin receptor activator (C.E.R.A.) in pediatric patients with chronic kidney disease (CKD) on peritoneal dialysis (PD) or hemodialysis (HD). METHODS IPPN and IPHN collect prospective data (baseline and every 6 months) from pediatric PD and HD centers worldwide. Demographics, clinical characteristics, dialysis information, treatment, laboratory parameters, number and causes of hospitalization events, and deaths were extracted for patients on C.E.R.A. treatment (IPPN: 2007-2021; IPHN: 2013-2021). RESULTS We analyzed 177 patients on PD (median age 10.6 years) and 52 patients on HD (median age 14.1 years) who had ≥ 1 observation while being treated with C.E.R.A. The median (interquartile range [IQR]) observation time under C.E.R.A. exposure was 6 (0-12.5) and 12 (0-18) months, respectively. Hemoglobin concentrations were stable over time; respective means (standard deviation) at last observation were 10.9 (1.7) g/dL and 10.4 (1.7) g/dL. Respective median (IQR) monthly C.E.R.A. doses at last observation were 3.5 (2.3-5.1) µg/kg, or 95 (62-145) µg/m2 and 2.1 (1.2-3.4) µg/kg, or 63 (40-98) µg/m2. Non-elective hospitalizations occurred in 102 (58%) PD and 32 (62%) HD patients. Seven deaths occurred (19.8 deaths per 1000 observation years). CONCLUSIONS C.E.R.A. was associated with efficient maintenance of hemoglobin concentrations in pediatric patients with CKD on dialysis, and appeared to have a favorable safety profile. The current analysis revealed no safety signals.
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Affiliation(s)
- Laura Kohlhas
- Institute of Medical Biometry, University of Heidelberg, Heidelberg, Germany
| | | | | | | | - Anja Sander
- Institute of Medical Biometry, University of Heidelberg, Heidelberg, Germany
| | - Hui-Kim Yap
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Republic of Singapore
| | - Karel Vondrak
- Department of Pediatrics and Transplantation Center, University Hospital Motol, 2nd Medical Faculty Prague, Charles University Prague, Prague, Czech Republic
| | - Paula A Coccia
- Division of Pediatric Nephrology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Francisco Cano
- Division of Pediatric Nephrology, Hospital Dr. Luis Calvo Mackenna, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Claus Peter Schmitt
- Division of Pediatric Nephrology, Center for Pediatrics and Adolescent Medicine, Heidelberg, Germany
| | - Bradley A Warady
- Division of Pediatric Nephrology, Children's Mercy Kansas City, Kansas City, MO, USA
| | - Franz Schaefer
- Division of Pediatric Nephrology, Center for Pediatrics and Adolescent Medicine, Heidelberg, Germany.
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Rutten-Jacobs L, McIver T, Reyes A, Pereira M, Rosenthal R, Parusel CT, Wagner KR, Doody R. Racial and ethnic diversity in global neuroscience clinical trials. Contemp Clin Trials Commun 2024; 37:101255. [PMID: 38292216 PMCID: PMC10824686 DOI: 10.1016/j.conctc.2024.101255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 11/23/2023] [Accepted: 01/01/2024] [Indexed: 02/01/2024] Open
Abstract
Background Despite efforts to increase diversity in neuroscience trials, racial and ethnic minority groups remain underrepresented. Disparities in clinical trial participation could reflect unequal opportunities to participate and may contribute to decreased generalizability of findings and failure to identify important differences in efficacy and safety outcomes. Methods We retrospectively reviewed the F. Hoffmann-La Roche database for global, multicenter, neuroscience clinical trials from February 2016 to February 2021 and summarized and stratified race and ethnicity distributions by clinical trial therapeutic area and by country. These data were then compared to national population data for each study's targeted age group (available for studies conducted in the US, Canada, and the UK). The underrepresentation or overrepresentation of each racial and ethnic group was summarized. Results The analysis population included 8015 participants from 47 countries. Globally, 85.6 % of participants were White, 7.1 % were Asian, 1.6 % were Black, 1.3 % were American Indian or Alaska Native, less than 0.1 % were Native Hawaiian or other Pacific Islander, 0.7 % were of multiple races, and 3.6 % were of other/unknown race. White individuals predominated in all but one trial. Black individuals were underrepresented in all trials but one. Asian individuals were overrepresented in approximately 20 % of trials. In the US, 7.3 % of participants were of Hispanic or Latino ethnicity vs 16.4 % of the US population. Conclusion The findings and learnings from this summary and analysis demonstrate the need for continued awareness and new approaches in designing studies that reflect population diversity.
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Affiliation(s)
- Loes Rutten-Jacobs
- Product Development Neuroscience, F. Hoffmann-La Roche Ltd, Basel, Switzerland
| | - Tammy McIver
- Product Development Data Sciences, Roche Products Ltd, Welwyn Garden City, UK
| | - Adriana Reyes
- Product Development Data Sciences, F. Hoffmann-La Roche Ltd, Basel, Switzerland
| | - Marta Pereira
- Pharma International, F. Hoffmann-La Roche Ltd, Amadora, Portugal
| | - Rachel Rosenthal
- Product Development Data Sciences, F. Hoffmann-La Roche Ltd, Basel, Switzerland
| | | | - Kathryn R. Wagner
- Product Development Neuroscience, F. Hoffmann-La Roche Ltd, Basel, Switzerland
| | - Rachelle Doody
- Product Development Neuroscience, F. Hoffmann-La Roche Ltd, Basel, Switzerland
- Genentech, Inc., A Member of the Roche Group, South San Francisco, CA, USA
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Furby H, Siadimas A, Rutten-Jacobs L, Rodrigues FB, Wild EJ. Natural History and Burden of Huntington's Disease in the UK: A Population-Based Cohort Study. Eur J Neurol 2022; 29:2249-2257. [PMID: 35514071 PMCID: PMC9542098 DOI: 10.1111/ene.15385] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 04/21/2022] [Accepted: 04/24/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Huntington's disease (HD) is a rare neurodegenerative disease that presents with progressive psychological, cognitive and motor impairment. These diverse symptoms place a high burden on the patient, families and the healthcare systems they rely on. This study aimed to describe the epidemiology and clinical burden in individuals with HD compared with controls from the general population. METHODS This cohort study utilised data from general practitioner (GP) medical records to estimate the prevalence and incidence of HD between Jan 2000 and Dec 2018. A cohort of incident HD cases were matched 1:3 to controls from the general population, in whom common clinical diagnoses, medications and healthcare interventions were compared at the time of first recorded diagnosis and at a time close to death. Incidence rates of common diagnoses and mortality were compared with matched controls in the time following HD diagnosis. RESULTS Prevalence of HD increased between 2000 and 2018, whilst incidence remained stable. Prevalence of psychiatric diagnoses and symptomatic treatments were higher in HD cases than controls. A higher relative risk of psychotic disorders, depression, insomnia, dementia, weight loss, pneumonia and falls was observed in HD cases. Risk of death was >4 times higher in HD, with a median survival of ~12 years from first recorded diagnosis. CONCLUSIONS This study demonstrates the significant and progressive clinical burden in individuals up to 18 years after first recorded diagnosis.
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Affiliation(s)
| | | | | | - Filipe B Rodrigues
- Huntington's Disease Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Edward J Wild
- Huntington's Disease Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
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Schaefer F, Benner L, Sander A, Rutten-Jacobs L, Hui Kim Y, Vondrak K, Coccia PA, Cano F, Meyer Reigner S, Studer M. MO1041: C.E.R.A. (Continuous Erythropoietin Receptor Activator—Methoxy Polyethylene Glycol Epoetin Beta) In Paediatric Dialysis Patients with Anaemia of Chronic Kidney Disease: Real-World Evidence from the IPDN and IPHN Registries. Nephrol Dial Transplant 2022. [DOI: 10.1093/ndt/gfac089.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
BACKGROUND AND AIMS
Continuous erythropoietin receptor activator—methoxy polyethylene glycol epoetin beta (C.E.R.A.) is a long-acting erythropoiesis-stimulating agent (ESA) approved for the treatment of anaemia associated with chronic kidney disease (CKD) in adults. In June 2018, the Food and Drug Administration approved the use of C.E.R.A. administered intravenously in patients on haemodialysis aged 5–<18 years switching from another ESA. This observational real-world study (MH40258) assessed the safety, dosing and haemoglobin (Hb) levels associated with C.E.R.A. in paediatric patients with CKD on dialysis.
METHOD
This was a non-interventional real-world study of patients from the International Paediatric Peritoneal Dialysis Network (IPPN) and the International Paediatric Hemodialysis Network (IPHN) registries. Demographics, clinical characteristics, dialysis information, treatment, laboratory parameters, number and causes of hospitalization events and deaths were reported in patients treated with C.E.R.A. from both registries (IPPN: 2007–2021; IPHN: 2013–2021).
RESULTS
Overall, 229 patients had at least one observation while being treated with C.E.R.A. and were analysed in this study; 177 on peritoneal dialysis (PD) (median age 10.6 years, interquartile range [IQR] 4.2–14.6) and 52 on haemodialysis (HD) (median age 14.1 years, IQR 10.4-16.2). The median observation time under C.E.R.A. exposure was 6 months (IQR 0–12.5) for PD patients and 12 months (0–18) for HD patients. 121 PD patients (68%) and 36 HD patients (69%) had ≥ 1 hospitalization, of whom 102/121 (84%) and 32/36 (89%), respectively, had non-elective hospitalizations. Median hospitalization surveillance time/patient was 13.5 months in the PD and 18.3 months in the HD cohorts. The most frequent causes for non-elective hospitalization were infections, reported as a cause in 56/177 (32%) patients in the PD cohort and 14/52 (27%) in the HD cohort and technique complications, in 41/177 (23%) patients in the PD cohort and 20/52 (38%) in the HD cohort. There were seven deaths (PD: 5 patients; HD: 2 patients), corresponding to an overall mortality rate of 19.8 cases per 1000 observation years. Causes of death were infections (n = 2), intracranial bleeding (n = 2), congestive heart failure (n = 2) and one case of sudden death at home. Hb levels remained stable over time with 47% of PD patients and 48% of HD patients having a Hb value within the range of 10–12 g/dL at their last observation. Mean [standard deviation (SD)] Hb levels at last observation were 10.9 (1.7) g/dL in the PD and 10.4 (1.7) g/dL in the HD cohort. The median monthly dose of C.E.R.A. at first visit was 100 (IQR 50–120) µg in the PD and 107 (80–129) µg in the HD cohort, while at last visit it was 100 (50–150) µg (PD) and 80 (54–129) µg (HD). While absolute C.E.R.A. dose increased with age, weight-related doses decreased substantially with age in both cohorts: in groups aged < 2, 2–<5, 5–<12 and 12–<18 years, respectively, the median monthly dose was 7.9, 5.4, 3.2 and 2.6 µg/kg at first observation and 5.1, 5.2, 3.0 and 3.0 µg/kg at last observation in the PD cohort. The age-related dosing differences were smaller when doses were normalized to body surface area (BSA) rather than body weight, with median doses at last visit of 114, 121, 87 and 98 µg/m2/month, respectively in the PD cohort. In the HD cohort, a similar pattern wasobserved regarding weight and BSA-based dosing, but overall C.E.R.A.dosing was generally lower over the course of the study in HD compared with PD patients. The median monthly C.E.R.A. dose at last observation was 3.5 (IQR 2.3– 5.1) µg/kg, or 95 (62–145) µg/m2 in the PD cohort and 2.1 (1.2–3.4) µg/kg, or 63 (40–98) µg/m2 in the HD cohort (Table).
CONCLUSION
Real-world data from the IPPN and IPHN registries indicated that C.E.R.A. treatment is associated with efficient maintenance of Hb levels in paediatric patients with CKD on dialysis. C.E.R.A. appeared to have a favourable safety profile; analysis of hospitalization rate and causes as well as patient mortality did not reveal any safety signals.
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Affiliation(s)
- Franz Schaefer
- Center for Paediatrics and Adolescent Medicine, Heidelberg, Germany
| | - Laura Benner
- University of Heidelberg, Institute of Medical Biometry, Heidelberg, Germany
| | - Anja Sander
- University of Heidelberg, Institute of Medical Biometry, Heidelberg, Germany
| | | | - Yap Hui Kim
- National University of Singapore, Department of Paediatrics, Yong Loo Lin School of Medicine, Singapore, Singapore
| | - Karel Vondrak
- University Hospital Motol, Department of Paediatrics and Transplantation Center, Prague, Czech Republic
| | - Paula A Coccia
- Hospital Italiano de Buenos Aires, Division of Paediatric Nephrology, Buenos Aires, Argentina
| | - Francisco Cano
- Universidad de Chile, Hospital Dr Luis Calvo Mackenna, Facultad de Medicina, Chile
| | | | - Milena Studer
- F. Hoffmann-La Roche Ltd, Grenzacherstrasse 124, Basel, Switzerland
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Abstract
Early prediction of risk of cardiovascular disease (CVD), including stroke, is a cornerstone of disease prevention. Clinical risk scores have been widely used for predicting CVD risk from known risk factors. Most CVDs have a substantial genetic component, which also has been confirmed for stroke in recent gene discovery efforts. However, the role of genetics in prediction of risk of CVD, including stroke, has been limited to testing for highly penetrant monogenic disorders. In contrast, the importance of polygenic variation, the aggregated effect of many common genetic variants across the genome with individually small effects, has become more apparent in the last 5 to 10 years, and powerful polygenic risk scores for CVD have been developed. Here we review the current state of the field of polygenic risk scores for CVD including stroke, and their potential to improve CVD risk prediction. We present findings and lessons from diseases such as coronary artery disease as these will likely be useful to inform future research in stroke polygenic risk prediction.
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Affiliation(s)
- Gad Abraham
- Cambridge Baker Systems Genomics Initiative, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
- Department of Clinical Pathology, University of Melbourne, Parkville, VIC, Australia
| | - Loes Rutten-Jacobs
- Personalized Health Care Data Science, Real World Data, F. Hoffmann-La Roche Ltd., Basel, Switzerland
| | - Michael Inouye
- Cambridge Baker Systems Genomics Initiative, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
- Department of Clinical Pathology, University of Melbourne, Parkville, VIC, Australia
- Cambridge Baker Systems Genomics Initiative, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- British Heart Foundation Centre of Research Excellence, University of Cambridge, Cambridge, UK
- National Institute for Health Research Cambridge Biomedical Research Centre, University of Cambridge and Cambridge University Hospitals, Cambridge, UK
- Health Data Research UK Cambridge, Wellcome Genome Campus and University of Cambridge, Cambridge, UK
- The Alan Turing Institute, London, UK
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6
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Gustavsson A, Raket LL, Lilja M, Rutten-Jacobs L, Fues Wahl H, Bagijn M, Stomrud E, Hansson O, Palmqvist S. Health utility in preclinical and prodromal Alzheimer's disease for establishing the value of new disease-modifying treatments-EQ-5D data from the Swedish BioFINDER study. Alzheimers Dement 2021; 17:1832-1842. [PMID: 33984179 DOI: 10.1002/alz.12355] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Revised: 02/24/2021] [Accepted: 03/25/2021] [Indexed: 11/12/2022]
Abstract
Quality of life and health utility are important outcomes for patients with Alzheimer's disease (AD) and central for demonstrating the value of new treatments. Estimates in biomarker-confirmed AD populations are missing, potentially delaying payer approval of treatment. We examined whether health utility, assessed with the EuroQoL-5 3-level version (EQ-5D-3L), differed between individuals with a positive or negative amyloid beta (Aβ) biomarker in patients with mild cognitive impairment (MCI) and cognitively unimpaired (CU) participants from the Swedish BioFINDER study (n = 578). Participants with prodromal AD (Aβ-positive MCI) reported better health utility (n = 79, mean = 0.81, 95% confidence interval [CI] 0.77-0.85) than Aβ-negative MCI (mean = 0.71, 95% CI 0.64-0.78), but worse than controls (Aβ-negative CU, mean = 0.87, 95% CI 0.86-0.89). Health utility in preclinical AD (Aβ-positive CU; mean = 0.86, 95% CI 0.83-0.89) was similar to controls. This relatively good health utility in prodromal AD suggests a larger value of delaying progression to dementia than previously anticipated and a great value of delaying clinical progression in preclinical AD.
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Affiliation(s)
- Anders Gustavsson
- Quantify Research, Stockholm, Sweden.,Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
| | - Lars Lau Raket
- H. Lundbeck A/S, Copenhagen, Denmark.,Clinical Memory Research Unit, Lund University, Lund, Sweden
| | | | - Loes Rutten-Jacobs
- Product Development Personalized Health Care, F. Hoffmann-La Roche Ltd., Basel, Switzerland
| | | | | | - Erik Stomrud
- Clinical Memory Research Unit, Clinical Sciences, Malmö, Lund University, Malmö, Sweden.,Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Oskar Hansson
- Clinical Memory Research Unit, Clinical Sciences, Malmö, Lund University, Malmö, Sweden.,Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Sebastian Palmqvist
- Clinical Memory Research Unit, Clinical Sciences, Malmö, Lund University, Malmö, Sweden.,Memory Clinic, Skåne University Hospital, Malmö, Sweden
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7
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Traylor M, Persyn E, Tomppo L, Klasson S, Abedi V, Bakker MK, Torres N, Li L, Bell S, Rutten-Jacobs L, Tozer DJ, Griessenauer CJ, Zhang Y, Pedersen A, Sharma P, Jimenez-Conde J, Rundek T, Grewal RP, Lindgren A, Meschia JF, Salomaa V, Havulinna A, Kourkoulis C, Crawford K, Marini S, Mitchell BD, Kittner SJ, Rosand J, Dichgans M, Jern C, Strbian D, Fernandez-Cadenas I, Zand R, Ruigrok Y, Rost N, Lemmens R, Rothwell PM, Anderson CD, Wardlaw J, Lewis CM, Markus HS. Genetic basis of lacunar stroke: a pooled analysis of individual patient data and genome-wide association studies. Lancet Neurol 2021; 20:351-361. [PMID: 33773637 PMCID: PMC8062914 DOI: 10.1016/s1474-4422(21)00031-4] [Citation(s) in RCA: 85] [Impact Index Per Article: 28.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 11/06/2020] [Accepted: 01/15/2021] [Indexed: 01/07/2023]
Abstract
BACKGROUND The genetic basis of lacunar stroke is poorly understood, with a single locus on 16q24 identified to date. We sought to identify novel associations and provide mechanistic insights into the disease. METHODS We did a pooled analysis of data from newly recruited patients with an MRI-confirmed diagnosis of lacunar stroke and existing genome-wide association studies (GWAS). Patients were recruited from hospitals in the UK as part of the UK DNA Lacunar Stroke studies 1 and 2 and from collaborators within the International Stroke Genetics Consortium. Cases and controls were stratified by ancestry and two meta-analyses were done: a European ancestry analysis, and a transethnic analysis that included all ancestry groups. We also did a multi-trait analysis of GWAS, in a joint analysis with a study of cerebral white matter hyperintensities (an aetiologically related radiological trait), to find additional genetic associations. We did a transcriptome-wide association study (TWAS) to detect genes for which expression is associated with lacunar stroke; identified significantly enriched pathways using multi-marker analysis of genomic annotation; and evaluated cardiovascular risk factors causally associated with the disease using mendelian randomisation. FINDINGS Our meta-analysis comprised studies from Europe, the USA, and Australia, including 7338 cases and 254 798 controls, of which 2987 cases (matched with 29 540 controls) were confirmed using MRI. Five loci (ICA1L-WDR12-CARF-NBEAL1, ULK4, SPI1-SLC39A13-PSMC3-RAPSN, ZCCHC14, ZBTB14-EPB41L3) were found to be associated with lacunar stroke in the European or transethnic meta-analyses. A further seven loci (SLC25A44-PMF1-BGLAP, LOX-ZNF474-LOC100505841, FOXF2-FOXQ1, VTA1-GPR126, SH3PXD2A, HTRA1-ARMS2, COL4A2) were found to be associated in the multi-trait analysis with cerebral white matter hyperintensities (n=42 310). Two of the identified loci contain genes (COL4A2 and HTRA1) that are involved in monogenic lacunar stroke. The TWAS identified associations between the expression of six genes (SCL25A44, ULK4, CARF, FAM117B, ICA1L, NBEAL1) and lacunar stroke. Pathway analyses implicated disruption of the extracellular matrix, phosphatidylinositol 5 phosphate binding, and roundabout binding (false discovery rate <0·05). Mendelian randomisation analyses identified positive associations of elevated blood pressure, history of smoking, and type 2 diabetes with lacunar stroke. INTERPRETATION Lacunar stroke has a substantial heritable component, with 12 loci now identified that could represent future treatment targets. These loci provide insights into lacunar stroke pathogenesis, highlighting disruption of the vascular extracellular matrix (COL4A2, LOX, SH3PXD2A, GPR126, HTRA1), pericyte differentiation (FOXF2, GPR126), TGF-β signalling (HTRA1), and myelination (ULK4, GPR126) in disease risk. FUNDING British Heart Foundation.
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Affiliation(s)
- Matthew Traylor
- Clinical Pharmacology and The Barts Heart Centre and NIHR Barts Biomedical Research Centre, Barts Health NHS Trust, William Harvey Research Institute, Queen Mary University of London, London, UK
| | - Elodie Persyn
- Department of Medical and Molecular Genetics, King's College London, London, UK
| | - Liisa Tomppo
- Department of Neurology, Helsinki University Hospital, Helsinki, Finland
| | - Sofia Klasson
- Department of Laboratory Medicine, Institute of Biomedicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Vida Abedi
- Department of Molecular and Functional Genomics, Weis Center for Research, Geisinger Health System, Danville, PA, USA
| | - Mark K Bakker
- Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, Netherlands
| | - Nuria Torres
- Stroke Pharmacogenomics and Genetics, Sant Pau Institute of Research, Hospital de la Santa Creu I Sant Pau, Barcelona, Spain
| | - Linxin Li
- Centre for the Prevention of Stroke and Dementia, Nuffield Department of Clinical Neuroscience, University of Oxford, Oxford, UK
| | - Steven Bell
- Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Loes Rutten-Jacobs
- Product Development Personalized Health Care, F Hoffmann-La Roche, Basel, Switzerland
| | - Daniel J Tozer
- Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Christoph J Griessenauer
- Neuroscience Institute, Geisinger Health System, Danville, PA, USA; Institute of Neurointervention, Paracelsus Medical University, Salzburg, Austria
| | - Yanfei Zhang
- Genomic Medicine Institute, Geisinger Health System, Danville, PA, USA
| | - Annie Pedersen
- Department of Laboratory Medicine, Institute of Biomedicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Pankaj Sharma
- Institute of Cardiovascular Research, Royal Holloway University of London, London, UK
| | - Jordi Jimenez-Conde
- Neurovascular Research Group, Department of Neurology of Hospital del Mar-IMIM (Institut Hospital del Mar d'Investigacions Mediques), Universitat Autonoma de Barcelona/DCEXS-Universitat Pompeu Fabra, Barcelona, Spain
| | - Tatjana Rundek
- Evelyn F McKnight Brain Institute, Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Raji P Grewal
- Neuroscience Institute, Saint Francis Medical Center, School of Health and Medical Sciences, Seton Hall University, South Orange, NJ, USA
| | - Arne Lindgren
- Department of Neurology, Skane University Hospital, Lund, Sweden; Department of Clinical Sciences Lund, Neurology, Lund University, Lund, Sweden
| | | | - Veikko Salomaa
- Department of Public Health Solutions, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Aki Havulinna
- Department of Public Health Solutions, Finnish Institute for Health and Welfare, Helsinki, Finland; Institute for Molecular Medicine Finland (FIMM HiLIFE), Helsinki, Finland
| | - Christina Kourkoulis
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA; Henry and Allison McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA, USA; Program in Medical & Population Genetics, Broad Institute of Harvard and MIT, Cambridge, MA, USA
| | - Katherine Crawford
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA; Program in Medical & Population Genetics, Broad Institute of Harvard and MIT, Cambridge, MA, USA
| | - Sandro Marini
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA; Program in Medical & Population Genetics, Broad Institute of Harvard and MIT, Cambridge, MA, USA
| | - Braxton D Mitchell
- Division of Endocrinology, Diabetes and Nutrition, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA; Geriatrics Research and Education Clinical Center, Baltimore Veterans Administration Medical Center, Baltimore, MD, USA
| | - Steven J Kittner
- Department of Neurology, University of Maryland School of Medicine, Baltimore, MD, USA; Geriatrics Research and Education Clinical Center, Baltimore Veterans Administration Medical Center, Baltimore, MD, USA
| | - Jonathan Rosand
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA; Henry and Allison McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA, USA; Department of Neurology, Massachusetts General Hospital, Boston, MA, USA; Program in Medical & Population Genetics, Broad Institute of Harvard and MIT, Cambridge, MA, USA
| | - Martin Dichgans
- Institute for Stroke and Dementia Research (ISD), LMU Munich, Munich, Germany; Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Christina Jern
- Department of Laboratory Medicine, Institute of Biomedicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Daniel Strbian
- Department of Neurology, Helsinki University Hospital, Helsinki, Finland; Clinical Neurosciences, University of Helsinki, Helsinki, Finland
| | - Israel Fernandez-Cadenas
- Stroke Pharmacogenomics and Genetics, Sant Pau Institute of Research, Hospital de la Santa Creu I Sant Pau, Barcelona, Spain; Neurovascular Research Laboratory and Neurovascular Unit, Institut de Recerca, Hospital Vall d'Hebron, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - Ramin Zand
- Neuroscience Institute, Geisinger Health System, Danville, PA, USA
| | - Ynte Ruigrok
- Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, Netherlands
| | - Natalia Rost
- J Philip Kistler Stroke Research Center, Massachusetts General Hospital, Boston, MA, USA
| | - Robin Lemmens
- Experimental Neurology, Department of Neurosciences, KU Leuven, Leuven, Belgium; VIB Center for Brain & Disease Research, Department of Neurology, University Hospitals Leuven, Leuven, Belgium
| | - Peter M Rothwell
- Centre for the Prevention of Stroke and Dementia, Nuffield Department of Clinical Neuroscience, University of Oxford, Oxford, UK
| | - Christopher D Anderson
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA; Henry and Allison McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA, USA; Department of Neurology, Massachusetts General Hospital, Boston, MA, USA; Program in Medical & Population Genetics, Broad Institute of Harvard and MIT, Cambridge, MA, USA
| | - Joanna Wardlaw
- Centre for Clinical Brain Sciences, UK Dementia Research Institute and Row Fogo Centre for Research into the Ageing Brain, University of Edinburgh, Edinburgh, UK
| | - Cathryn M Lewis
- Department of Medical and Molecular Genetics, King's College London, London, UK; Social, Genetic, and Developmental Psychiatry Centre, King's College London, London, UK
| | - Hugh S Markus
- Clinical Neurosciences, University of Cambridge, Cambridge, UK.
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8
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Malik R, Chauhan G, Traylor M, Sargurupremraj M, Okada Y, Mishra A, Rutten-Jacobs L, Giese AK, van der Laan SW, Gretarsdottir S, Anderson CD, Chong M, Adams HHH, Ago T, Almgren P, Amouyel P, Ay H, Bartz TM, Benavente OR, Bevan S, Boncoraglio GB, Brown RD, Butterworth AS, Carrera C, Carty CL, Chasman DI, Chen WM, Cole JW, Correa A, Cotlarciuc I, Cruchaga C, Danesh J, de Bakker PIW, DeStefano AL, den Hoed M, Duan Q, Engelter ST, Falcone GJ, Gottesman RF, Grewal RP, Gudnason V, Gustafsson S, Haessler J, Harris TB, Hassan A, Havulinna AS, Heckbert SR, Holliday EG, Howard G, Hsu FC, Hyacinth HI, Ikram MA, Ingelsson E, Irvin MR, Jian X, Jiménez-Conde J, Johnson JA, Jukema JW, Kanai M, Keene KL, Kissela BM, Kleindorfer DO, Kooperberg C, Kubo M, Lange LA, Langefeld CD, Langenberg C, Launer LJ, Lee JM, Lemmens R, Leys D, Lewis CM, Lin WY, Lindgren AG, Lorentzen E, Magnusson PK, Maguire J, Manichaikul A, McArdle PF, Meschia JF, Mitchell BD, Mosley TH, Nalls MA, Ninomiya T, O'Donnell MJ, Psaty BM, Pulit SL, Rannikmäe K, Reiner AP, Rexrode KM, Rice K, Rich SS, Ridker PM, Rost NS, Rothwell PM, Rotter JI, Rundek T, Sacco RL, Sakaue S, Sale MM, Salomaa V, Sapkota BR, Schmidt R, Schmidt CO, Schminke U, Sharma P, Slowik A, Sudlow CLM, Tanislav C, Tatlisumak T, Taylor KD, Thijs VNS, Thorleifsson G, Thorsteinsdottir U, Tiedt S, Trompet S, Tzourio C, van Duijn CM, Walters M, Wareham NJ, Wassertheil-Smoller S, Wilson JG, Wiggins KL, Yang Q, Yusuf S, Bis JC, Pastinen T, Ruusalepp A, Schadt EE, Koplev S, Björkegren JLM, Codoni V, Civelek M, Smith NL, Trégouët DA, Christophersen IE, Roselli C, Lubitz SA, Ellinor PT, Tai ES, Kooner JS, Kato N, He J, van der Harst P, Elliott P, Chambers JC, Takeuchi F, Johnson AD, Sanghera DK, Melander O, Jern C, Strbian D, Fernandez-Cadenas I, Longstreth WT, Rolfs A, Hata J, Woo D, Rosand J, Pare G, Hopewell JC, Saleheen D, Stefansson K, Worrall BB, Kittner SJ, Seshadri S, Fornage M, Markus HS, Howson JMM, Kamatani Y, Debette S, Dichgans M. Publisher Correction: Multiancestry genome-wide association study of 520,000 subjects identifies 32 loci associated with stroke and stroke subtypes. Nat Genet 2019; 51:1192-1193. [PMID: 31160810 DOI: 10.1038/s41588-019-0449-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
An amendment to this paper has been published and can be accessed via a link at the top of the paper.
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Affiliation(s)
- Rainer Malik
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
| | - Ganesh Chauhan
- Centre for Brain Research, Indian Institute of Science, Bangalore, India
- INSERM U1219 Bordeaux Population Health Research Center, University of Bordeaux, Bordeaux, France
| | - Matthew Traylor
- Stroke Research Group, Division of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Muralidharan Sargurupremraj
- INSERM U1219 Bordeaux Population Health Research Center, University of Bordeaux, Bordeaux, France
- Department of Neurology, Institute for Neurodegenerative Disease, Bordeaux University Hospital, Bordeaux, France
| | - Yukinori Okada
- Laboratory for Statistical Analysis, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
- Department of Statistical Genetics, Osaka University Graduate School of Medicine, Osaka, Japan
- Laboratory of Statistical Immunology, Immunology Frontier Research Center (WPI-IFReC), Osaka University, Suita, Japan
| | - Aniket Mishra
- INSERM U1219 Bordeaux Population Health Research Center, University of Bordeaux, Bordeaux, France
- Department of Neurology, Institute for Neurodegenerative Disease, Bordeaux University Hospital, Bordeaux, France
| | - Loes Rutten-Jacobs
- Stroke Research Group, Division of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Anne-Katrin Giese
- Department of Neurology, Massachusetts General Hospital (MGH), Harvard Medical School, Boston, MA, USA
| | - Sander W van der Laan
- Laboratory of Experimental Cardiology, Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, University of Utrecht, Utrecht, the Netherlands
| | | | - Christopher D Anderson
- Center for Genomic Medicine, MGH, Boston, MA, USA
- J. Philip Kistler Stroke Research Center, Department of Neurology, MGH, Boston, MA, USA
- Program in Medical and Population Genetics, Broad Institute, Cambridge, MA, USA
| | - Michael Chong
- Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada
| | - Hieab H H Adams
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
- Department of Radiology and Nuclear Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Tetsuro Ago
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Peter Almgren
- Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Philippe Amouyel
- INSERM, Institut Pasteur de Lille, LabEx DISTALZ-UMR1167, Risk Factors and Molecular Determinants of Aging-Related Diseases, Université Lille, Lille, France
- Centre Hospitalier Université Lille, Epidemiology and Public Health Department, Lille, France
| | - Hakan Ay
- J. Philip Kistler Stroke Research Center, Department of Neurology, MGH, Boston, MA, USA
- AA Martinos Center for Biomedical Imaging, Department of Radiology, MGH, Harvard Medical School, Boston, MA, USA
| | - Traci M Bartz
- Cardiovascular Health Research Unit, Departments of Biostatistics and Medicine, University of Washington, Seattle, WA, USA
| | - Oscar R Benavente
- Division of Neurology, Faculty of Medicine, Brain Research Center, University of British Columbia, Vancouver, British Columbia, Canada
| | - Steve Bevan
- School of Life Science, University of Lincoln, Lincoln, UK
| | - Giorgio B Boncoraglio
- Department of Cerebrovascular Diseases, Fondazione IRCCS Istituto Neurologico 'Carlo Besta', Milan, Italy
| | - Robert D Brown
- Department of Neurology, Mayo Clinic Rochester, Rochester, MN, USA
| | - Adam S Butterworth
- MRC/BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- National Institute for Health Research Blood and Transplant Research Unit in Donor Health and Genomics, University of Cambridge, Cambridge, UK
| | - Caty Carrera
- Neurovascular Research Laboratory, Vall d'Hebron Institut of Research, Neurology and Medicine Departments-Universitat Autònoma de Barcelona, Vall d'Hebrón Hospital, Barcelona, Spain
- Stroke Pharmacogenomics and Genetics, Fundacio Docència i Recerca MutuaTerrassa, Terrassa, Spain
| | - Cara L Carty
- Children's Research Institute, Children's National Medical Center, Washington, DC, USA
- Center for Translational Science, George Washington University, Washington, DC, USA
| | - Daniel I Chasman
- Division of Preventive Medicine, Brigham and Women's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Wei-Min Chen
- Center for Public Health Genomics, Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA
| | - John W Cole
- Department of Neurology, University of Maryland School of Medicine and Baltimore VAMC, Baltimore, MD, USA
| | - Adolfo Correa
- Departments of Medicine, Pediatrics and Population Health Science, University of Mississippi Medical Center, Jackson, MS, USA
| | - Ioana Cotlarciuc
- Institute of Cardiovascular Research, Royal Holloway University of London, London, UK, and Ashford and St Peters Hospital, Surrey, UK
| | - Carlos Cruchaga
- Department of Psychiatry, Hope Center Program on Protein Aggregation and Neurodegeneration (HPAN), Washington University School of Medicine, St. Louis, MO, USA
- Department of Developmental Biology, Washington University School of Medicine, St. Louis, MO, USA
| | - John Danesh
- MRC/BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- NIHR Blood and Transplant Research Unit in Donor Health and Genomics, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Wellcome Trust Sanger Institute, Hinxton, Cambridge, UK
- British Heart Foundation, Cambridge Centre of Excellence, Department of Medicine, University of Cambridge, Cambridge, UK
| | - Paul I W de Bakker
- Department of Medical Genetics, University Medical Center Utrecht, Utrecht, the Netherlands
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Anita L DeStefano
- Boston University School of Public Health, Boston, MA, USA
- Framingham Heart Study, Framingham, MA, USA
| | - Marcel den Hoed
- Department of Immunology, Genetics and Pathology and Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Qing Duan
- Department of Genetics, University of North Carolina, Chapel Hill, NC, USA
| | - Stefan T Engelter
- Department of Neurology and Stroke Center, Basel University Hospital, Basel, Switzerland
- Neurorehabilitation Unit, University of Basel and University Center for Medicine of Aging and Rehabilitation Basel, Felix Platter Hospital, Basel, Switzerland
| | - Guido J Falcone
- Department of Neurology, Yale University School of Medicine, New Haven, CT, USA
- Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, MA, USA
| | - Rebecca F Gottesman
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Raji P Grewal
- Neuroscience Institute, SF Medical Center, Trenton, NJ, USA
| | - Vilmundur Gudnason
- Icelandic Heart Association Research Institute, Kopavogur, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Stefan Gustafsson
- Department of Medical Sciences, Molecular Epidemiology and Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Jeffrey Haessler
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Tamara B Harris
- Laboratory of Epidemiology and Population Science, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
| | - Ahamad Hassan
- Department of Neurology, Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Aki S Havulinna
- National Institute for Health and Welfare, Helsinki, Finland
- FIMM-Institute for Molecular Medicine Finland, Helsinki, Finland
| | - Susan R Heckbert
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Elizabeth G Holliday
- Public Health Stream, Hunter Medical Research Institute, New Lambton, New South Wales, Australia
- Faculty of Health and Medicine, University of Newcastle, Newcastle, New South Wales, Australia
| | - George Howard
- School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Fang-Chi Hsu
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Hyacinth I Hyacinth
- Aflac Cancer and Blood Disorder Center, Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Erik Ingelsson
- Department of Medicine, Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, CA, USA
- Department of Medical Sciences, Molecular Epidemiology and Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Marguerite R Irvin
- Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Xueqiu Jian
- Brown Foundation Institute of Molecular Medicine, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Jordi Jiménez-Conde
- Neurovascular Research Group (NEUVAS), Neurology Department, Institut Hospital del Mar d'Investigació Mèdica, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Julie A Johnson
- Department of Pharmacotherapy and Translational Research and Center for Pharmacogenomics, University of Florida, College of Pharmacy, Gainesville, FL, USA
- Division of Cardiovascular Medicine, College of Medicine, University of Florida, Gainesville, FL, USA
| | - J Wouter Jukema
- Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Masahiro Kanai
- Laboratory for Statistical Analysis, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
- Department of Statistical Genetics, Osaka University Graduate School of Medicine, Osaka, Japan
- Program in Bioinformatics and Integrative Genomics, Harvard Medical School, Boston, MA, USA
| | - Keith L Keene
- Department of Biology, East Carolina University, Greenville, NC, USA
- Center for Health Disparities, East Carolina University, Greenville, NC, USA
| | - Brett M Kissela
- University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | | | - Charles Kooperberg
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Michiaki Kubo
- RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | - Leslie A Lange
- Department of Medicine, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO, USA
| | - Carl D Langefeld
- Center for Public Health Genomics and Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Claudia Langenberg
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge, UK
| | - Lenore J Launer
- Intramural Research Program, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
| | - Jin-Moo Lee
- Department of Neurology, Radiology, and Biomedical Engineering, Washington University School of Medicine, St. Louis, MO, USA
| | - Robin Lemmens
- Department of Neurosciences, Experimental Neurology, KU Leuven-University of Leuven, Leuven, Belgium
- VIB Center for Brain & Disease Research, University Hospitals Leuven, Department of Neurology, Leuven, Belgium
| | - Didier Leys
- INSERM U 1171, CHU Lille, Université Lille, Lille, France
| | - Cathryn M Lewis
- Department of Medical and Molecular Genetics, King's College London, London, UK
- SGDP Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Wei-Yu Lin
- MRC/BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Northern Institute for Cancer Research, Newcastle University, Newcastle, UK
| | - Arne G Lindgren
- Department of Clinical Sciences Lund, Neurology, Lund University, Lund, Sweden
- Department of Neurology and Rehabilitation Medicine, Skåne University Hospital, Lund, Sweden
| | - Erik Lorentzen
- Bioinformatics Core Facility, University of Gothenburg, Gothenburg, Sweden
| | - Patrik K Magnusson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Jane Maguire
- University of Technology Sydney, Faculty of Health, Ultimo, New South Wales, Australia
| | - Ani Manichaikul
- Center for Public Health Genomics, Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA
| | - Patrick F McArdle
- Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | | | - Braxton D Mitchell
- Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
- Geriatrics Research and Education Clinical Center, Baltimore Veterans Administration Medical Center, Baltimore, MD, USA
| | - Thomas H Mosley
- Division of Geriatrics, School of Medicine, University of Mississippi Medical Center, Jackson, MS, USA
- Memory Impairment and Neurodegenerative Dementia Center, University of Mississippi Medical Center, Jackson, MS, USA
| | - Michael A Nalls
- Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
- Data Tecnica International, Glen Echo, MD, USA
| | - Toshiharu Ninomiya
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Martin J O'Donnell
- Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada
- Clinical Research Facility, Department of Medicine, NUI Galway, Galway, Ireland
| | - Bruce M Psaty
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, USA
- Department of Epidemiology, University of Washington, Seattle, WA, USA
- Department of Health Services, University of Washington, Seattle, WA, USA
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | - Sara L Pulit
- Department of Medical Genetics, University Medical Center Utrecht, Utrecht, the Netherlands
- Brain Center Rudolf Magnus, Department of Neurology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Kristiina Rannikmäe
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Alexander P Reiner
- Department of Epidemiology, University of Washington, Seattle, WA, USA
- Fred Hutchinson Cancer Research Center, University of Washington, Seattle, WA, USA
| | - Kathryn M Rexrode
- Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Kenneth Rice
- Department of Biostatistics, University of Washington, Seattle, WA, USA
| | - Stephen S Rich
- Center for Public Health Genomics, Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA
| | - Paul M Ridker
- Division of Preventive Medicine, Brigham and Women's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Natalia S Rost
- Department of Neurology, Massachusetts General Hospital (MGH), Harvard Medical School, Boston, MA, USA
- J. Philip Kistler Stroke Research Center, Department of Neurology, MGH, Boston, MA, USA
| | - Peter M Rothwell
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Jerome I Rotter
- Institute for Translational Genomics and Population Sciences, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA
- Division of Genomic Outcomes, Department of Pediatrics, Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Tatjana Rundek
- Department of Neurology, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Ralph L Sacco
- Department of Neurology, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Saori Sakaue
- Department of Statistical Genetics, Osaka University Graduate School of Medicine, Osaka, Japan
- Department of Allergy and Rheumatology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Michele M Sale
- Center for Public Health Genomics, University of Virginia, Charlottesville, VA, USA
| | - Veikko Salomaa
- National Institute for Health and Welfare, Helsinki, Finland
| | - Bishwa R Sapkota
- Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Reinhold Schmidt
- Department of Neurology, Medical University of Graz, Graz, Austria
| | - Carsten O Schmidt
- Institute for Community Medicine, SHIP-KEF, University Medicine Greifswald, Greifswald, Germany
| | - Ulf Schminke
- Department of Neurology, University Medicine Greifswald, Greifswald, Germany
| | - Pankaj Sharma
- Institute of Cardiovascular Research, Royal Holloway University of London, London, UK, and Ashford and St Peters Hospital, Surrey, UK
| | - Agnieszka Slowik
- Department of Neurology, Jagiellonian University, Krakow, Poland
| | - Cathie L M Sudlow
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | | | - Turgut Tatlisumak
- Department of Clinical Neurosciences/Neurology, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
- Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Kent D Taylor
- Institute for Translational Genomics and Population Sciences, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA
- Division of Genomic Outcomes, Department of Pediatrics, Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Vincent N S Thijs
- Stroke Division, Florey Institute of Neuroscience and Mental Health, University of Melbourne, Heidelberg, Victoria, Australia
- Austin Health, Department of Neurology, Heidelberg, Victoria, Australia
| | | | | | - Steffen Tiedt
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
| | - Stella Trompet
- Department of Internal Medicine, Section Gerontology and Geriatrics, Leiden University Medical Center, Leiden, the Netherlands
| | - Christophe Tzourio
- INSERM U1219 Bordeaux Population Health Research Center, University of Bordeaux, Bordeaux, France
- INSERM, U1219, Bordeaux, France
- Department of Public Health, Bordeaux University Hospital, Bordeaux, France
| | - Cornelia M van Duijn
- Genetic Epidemiology Unit, Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
- Center for Medical Systems Biology, Leiden, the Netherlands
| | - Matthew Walters
- School of Medicine, Dentistry and Nursing at the University of Glasgow, Glasgow, UK
| | - Nicholas J Wareham
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge, UK
| | - Sylvia Wassertheil-Smoller
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, New York, NY, USA
| | - James G Wilson
- Department of Physiology and Biophysics, University of Mississippi Medical Center, Jackson, MS, USA
| | - Kerri L Wiggins
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, USA
| | - Qiong Yang
- Boston University School of Public Health, Boston, MA, USA
| | - Salim Yusuf
- Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada
| | - Joshua C Bis
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, USA
| | - Tomi Pastinen
- Department of Human Genetics, McGill University, Montreal, Quebec, Canada
| | - Arno Ruusalepp
- Department of Pathophysiology, Institute of Biomedicine and Translation Medicine, University of Tartu, Tartu, Estonia
- Department of Cardiac Surgery, Tartu University Hospital, Tartu, Estonia
- Clinical Gene Networks AB, Stockholm, Sweden
| | - Eric E Schadt
- Department of Genetics and Genomic Sciences, Icahn Institute for Genomics and Multiscale Biology Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Simon Koplev
- Department of Genetics and Genomic Sciences, Icahn Institute for Genomics and Multiscale Biology Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Johan L M Björkegren
- Department of Genetics and Genomic Sciences, Icahn Institute for Genomics and Multiscale Biology Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Pathophysiology, Institute of Biomedicine and Translation Medicine, Biomeedikum, University of Tartu, Tartu, Estonia
- Integrated Cardio Metabolic Centre, Department of Medicine, Karolinska Institutet, Karolinska Universitetssjukhuset, Huddinge, Sweden
- Clinical Gene Networks AB, Stockholm, Sweden
| | - Veronica Codoni
- UPMC Univ. Paris 06, INSERM, UMR_S 1166, Team Genomics & Pathophysiology of Cardiovascular Diseases, Sorbonne Universités, Paris, France
- ICAN Institute for Cardiometabolism and Nutrition, Paris, France
| | - Mete Civelek
- Center for Public Health Genomics, University of Virginia, Charlottesville, VA, USA
- Department of Biomedical Engineering, University of Virginia, Charlottesville, VA, USA
| | - Nicholas L Smith
- Department of Epidemiology, University of Washington, Seattle, WA, USA
- Group Health Research Institute, Group Health Cooperative, Seattle, WA, USA
- Seattle Epidemiologic Research and Information Center, VA Office of Research and Development, Seattle, WA, USA
| | - David A Trégouët
- UPMC Univ. Paris 06, INSERM, UMR_S 1166, Team Genomics & Pathophysiology of Cardiovascular Diseases, Sorbonne Universités, Paris, France
- ICAN Institute for Cardiometabolism and Nutrition, Paris, France
| | - Ingrid E Christophersen
- Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, MA, USA
- Cardiovascular Research Center, MGH, Boston, MA, USA
- Department of Medical Research, Bærum Hospital, Vestre Viken Hospital Trust, Gjettum, Norway
| | - Carolina Roselli
- Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, MA, USA
| | - Steven A Lubitz
- Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, MA, USA
- Cardiovascular Research Center, MGH, Boston, MA, USA
| | - Patrick T Ellinor
- Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, MA, USA
- Cardiovascular Research Center, MGH, Boston, MA, USA
| | - E Shyong Tai
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Jaspal S Kooner
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Norihiro Kato
- Department of Gene Diagnostics and Therapeutics, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan
| | - Jiang He
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Pim van der Harst
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Paul Elliott
- MRC-PHE Centre for Environment and Health, School of Public Health, Department of Epidemiology and Biostatistics and the NIHR Imperial Biomedical Research Centre, Imperial College London, London, UK
| | - John C Chambers
- Department of Epidemiology and Biostatistics, Imperial College London, London, UK
- Department of Cardiology, Ealing Hospital NHS Trust, Southall, UK
| | - Fumihiko Takeuchi
- Department of Gene Diagnostics and Therapeutics, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan
| | - Andrew D Johnson
- Framingham Heart Study, Framingham, MA, USA
- National Heart, Lung and Blood Research Institute, Division of Intramural Research, Population Sciences Branch, Framingham, MA, USA
| | - Dharambir K Sanghera
- Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Oklahoma Center for Neuroscience, Oklahoma City, OK, USA
| | - Olle Melander
- Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Christina Jern
- Department of Pathology and Genetics, Institute of Biomedicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Daniel Strbian
- Department of Neurology, Helsinki University Hospital, Helsinki, Finland
- Clinical Neurosciences, Neurology, University of Helsinki, Helsinki, Finland
| | - Israel Fernandez-Cadenas
- Neurovascular Research Laboratory, Vall d'Hebron Institut of Research, Neurology and Medicine Departments-Universitat Autònoma de Barcelona, Vall d'Hebrón Hospital, Barcelona, Spain
- Stroke Pharmacogenomics and Genetics, Fundacio Docència i Recerca MutuaTerrassa, Terrassa, Spain
| | - W T Longstreth
- Department of Epidemiology, University of Washington, Seattle, WA, USA
- Department of Neurology, University of Washington, Seattle, WA, USA
| | - Arndt Rolfs
- Albrecht Kossel Institute, University Clinic of Rostock, Rostock, Germany
| | - Jun Hata
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Daniel Woo
- University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Jonathan Rosand
- Center for Genomic Medicine, MGH, Boston, MA, USA
- J. Philip Kistler Stroke Research Center, Department of Neurology, MGH, Boston, MA, USA
- Program in Medical and Population Genetics, Broad Institute, Cambridge, MA, USA
| | - Guillaume Pare
- Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada
| | - Jemma C Hopewell
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Danish Saleheen
- Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Kari Stefansson
- deCODE genetics/AMGEN Inc., Reykjavik, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Bradford B Worrall
- Departments of Neurology and Public Health Sciences, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Steven J Kittner
- Department of Neurology, University of Maryland School of Medicine and Baltimore VAMC, Baltimore, MD, USA
| | - Sudha Seshadri
- Framingham Heart Study, Framingham, MA, USA
- Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, University of Texas Health Sciences Center, San Antonio, San Antonio, TX, USA
| | - Myriam Fornage
- Brown Foundation Institute of Molecular Medicine, University of Texas Health Science Center at Houston, Houston, TX, USA
- Human Genetics Center, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Hugh S Markus
- Stroke Research Group, Division of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Joanna M M Howson
- MRC/BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Yoichiro Kamatani
- Laboratory for Statistical Analysis, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Stephanie Debette
- INSERM U1219 Bordeaux Population Health Research Center, University of Bordeaux, Bordeaux, France.
- Department of Neurology, Institute for Neurodegenerative Disease, Bordeaux University Hospital, Bordeaux, France.
| | - Martin Dichgans
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany.
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany.
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany.
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Traylor M, Tozer DJ, Croall ID, Lisiecka-Ford DM, Olorunda AO, Boncoraglio G, Dichgans M, Lemmens R, Rosand J, Rost NS, Rothwell PM, Sudlow CLM, Thijs V, Rutten-Jacobs L, Markus HS. Genetic variation in PLEKHG1 is associated with white matter hyperintensities (n = 11,226). Neurology 2019; 92:e749-e757. [PMID: 30659137 PMCID: PMC6396967 DOI: 10.1212/wnl.0000000000006952] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Accepted: 10/15/2018] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE To identify novel genetic associations with white matter hyperintensities (WMH). METHODS We performed a genome-wide association meta-analysis of WMH volumes in 11,226 individuals, including 8,429 population-based individuals from UK Biobank and 2,797 stroke patients. Replication of novel loci was performed in an independent dataset of 1,202 individuals. In all studies, WMH were quantified using validated automated or semi-automated methods. Imputation was to either the Haplotype Reference Consortium or 1,000 Genomes Phase 3 panels. RESULTS We identified a locus at genome-wide significance in an intron of PLEKHG1 (rs275350, β [SE] = 0.071 [0.013]; p = 1.6 × 10-8), a Rho guanine nucleotide exchange factor that is involved in reorientation of cells in the vascular endothelium. This association was validated in an independent sample (overall p value, 2.4 × 10-9). The same single nucleotide polymorphism was associated with all ischemic stroke (odds ratio [OR] [95% confidence interval (CI)] 1.07 [1.03-1.12], p = 0.00051), most strongly with the small vessel subtype (OR [95% CI] 1.09 [1.00-1.19], p = 0.044). Previous associations at 17q25 and 2p16 reached genome-wide significance in this analysis (rs3744020; β [SE] = 0.106 [0.016]; p = 1.2 × 10-11 and rs7596872; β [SE] = 0.143 [0.021]; p = 3.4 × 10-12). All identified associations with WMH to date explained 1.16% of the trait variance in UK Biobank, equivalent to 6.4% of the narrow-sense heritability. CONCLUSIONS Genetic variation in PLEKHG1 is associated with WMH and ischemic stroke, most strongly with the small vessel subtype, suggesting it acts by promoting small vessel arteriopathy.
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Affiliation(s)
- Matthew Traylor
- From the Department of Clinical Neurosciences, Stroke Research Group (M.T., D.J.T., I.D.C., D.M.L.F., A.O.O., L.R.-J., H.S.M.), University of Cambridge, UK; Department of Cerebrovascular Diseases (G.B.), Fondazione IRCCS Istituto Neurologico "Carlo Besta," Milan, Italy; Institute for Stroke and Dementia Research (M.D.), Klinikum der Universität München, Ludwig-Maximilians-Universität München, Munich; German Center for Neurodegenerative Diseases (DZNE) and Munich Cluster for Systems Neurology (SyNergy) (M.D.), Germany; Department of Neurosciences, Experimental Neurology and Leuven Research Institute for Neuroscience and Disease (LIND) (R.L.), KU Leuven-University of Leuven; Department of Neurology (R.L.), University Hospitals Leuven; Laboratory of Neurobiology (R.L.), VIB Center for Brain and Disease Research, Leuven, Belgium; Center for Human Genetic Research (J.R.) and Division of Neurocritical Care and Emergency Neurology (J.R.) and J. Philip Kistler Stroke Research Center (J.R., N.S.R.), Department of Neurology, Massachusetts General Hospital, Boston; Nuffield Department of Clinical Neurosciences (Clinical Neurology), Stroke Prevention Research Unit (P.M.R.), University of Oxford; Centre for Clinical Brain Sciences and Institute for Genetics and Molecular Medicine (C.L.M.S.), University of Edinburgh, UK; Stroke Division, Florey Institute of Neuroscience and Mental Health (V.T.), University of Melbourne; and Department of Neurology (V.T.), Austin Health, Heidelberg, Victoria, Australia.
| | - Daniel J Tozer
- From the Department of Clinical Neurosciences, Stroke Research Group (M.T., D.J.T., I.D.C., D.M.L.F., A.O.O., L.R.-J., H.S.M.), University of Cambridge, UK; Department of Cerebrovascular Diseases (G.B.), Fondazione IRCCS Istituto Neurologico "Carlo Besta," Milan, Italy; Institute for Stroke and Dementia Research (M.D.), Klinikum der Universität München, Ludwig-Maximilians-Universität München, Munich; German Center for Neurodegenerative Diseases (DZNE) and Munich Cluster for Systems Neurology (SyNergy) (M.D.), Germany; Department of Neurosciences, Experimental Neurology and Leuven Research Institute for Neuroscience and Disease (LIND) (R.L.), KU Leuven-University of Leuven; Department of Neurology (R.L.), University Hospitals Leuven; Laboratory of Neurobiology (R.L.), VIB Center for Brain and Disease Research, Leuven, Belgium; Center for Human Genetic Research (J.R.) and Division of Neurocritical Care and Emergency Neurology (J.R.) and J. Philip Kistler Stroke Research Center (J.R., N.S.R.), Department of Neurology, Massachusetts General Hospital, Boston; Nuffield Department of Clinical Neurosciences (Clinical Neurology), Stroke Prevention Research Unit (P.M.R.), University of Oxford; Centre for Clinical Brain Sciences and Institute for Genetics and Molecular Medicine (C.L.M.S.), University of Edinburgh, UK; Stroke Division, Florey Institute of Neuroscience and Mental Health (V.T.), University of Melbourne; and Department of Neurology (V.T.), Austin Health, Heidelberg, Victoria, Australia
| | - Iain D Croall
- From the Department of Clinical Neurosciences, Stroke Research Group (M.T., D.J.T., I.D.C., D.M.L.F., A.O.O., L.R.-J., H.S.M.), University of Cambridge, UK; Department of Cerebrovascular Diseases (G.B.), Fondazione IRCCS Istituto Neurologico "Carlo Besta," Milan, Italy; Institute for Stroke and Dementia Research (M.D.), Klinikum der Universität München, Ludwig-Maximilians-Universität München, Munich; German Center for Neurodegenerative Diseases (DZNE) and Munich Cluster for Systems Neurology (SyNergy) (M.D.), Germany; Department of Neurosciences, Experimental Neurology and Leuven Research Institute for Neuroscience and Disease (LIND) (R.L.), KU Leuven-University of Leuven; Department of Neurology (R.L.), University Hospitals Leuven; Laboratory of Neurobiology (R.L.), VIB Center for Brain and Disease Research, Leuven, Belgium; Center for Human Genetic Research (J.R.) and Division of Neurocritical Care and Emergency Neurology (J.R.) and J. Philip Kistler Stroke Research Center (J.R., N.S.R.), Department of Neurology, Massachusetts General Hospital, Boston; Nuffield Department of Clinical Neurosciences (Clinical Neurology), Stroke Prevention Research Unit (P.M.R.), University of Oxford; Centre for Clinical Brain Sciences and Institute for Genetics and Molecular Medicine (C.L.M.S.), University of Edinburgh, UK; Stroke Division, Florey Institute of Neuroscience and Mental Health (V.T.), University of Melbourne; and Department of Neurology (V.T.), Austin Health, Heidelberg, Victoria, Australia
| | - Danuta M Lisiecka-Ford
- From the Department of Clinical Neurosciences, Stroke Research Group (M.T., D.J.T., I.D.C., D.M.L.F., A.O.O., L.R.-J., H.S.M.), University of Cambridge, UK; Department of Cerebrovascular Diseases (G.B.), Fondazione IRCCS Istituto Neurologico "Carlo Besta," Milan, Italy; Institute for Stroke and Dementia Research (M.D.), Klinikum der Universität München, Ludwig-Maximilians-Universität München, Munich; German Center for Neurodegenerative Diseases (DZNE) and Munich Cluster for Systems Neurology (SyNergy) (M.D.), Germany; Department of Neurosciences, Experimental Neurology and Leuven Research Institute for Neuroscience and Disease (LIND) (R.L.), KU Leuven-University of Leuven; Department of Neurology (R.L.), University Hospitals Leuven; Laboratory of Neurobiology (R.L.), VIB Center for Brain and Disease Research, Leuven, Belgium; Center for Human Genetic Research (J.R.) and Division of Neurocritical Care and Emergency Neurology (J.R.) and J. Philip Kistler Stroke Research Center (J.R., N.S.R.), Department of Neurology, Massachusetts General Hospital, Boston; Nuffield Department of Clinical Neurosciences (Clinical Neurology), Stroke Prevention Research Unit (P.M.R.), University of Oxford; Centre for Clinical Brain Sciences and Institute for Genetics and Molecular Medicine (C.L.M.S.), University of Edinburgh, UK; Stroke Division, Florey Institute of Neuroscience and Mental Health (V.T.), University of Melbourne; and Department of Neurology (V.T.), Austin Health, Heidelberg, Victoria, Australia
| | - Abiodun Olubunmi Olorunda
- From the Department of Clinical Neurosciences, Stroke Research Group (M.T., D.J.T., I.D.C., D.M.L.F., A.O.O., L.R.-J., H.S.M.), University of Cambridge, UK; Department of Cerebrovascular Diseases (G.B.), Fondazione IRCCS Istituto Neurologico "Carlo Besta," Milan, Italy; Institute for Stroke and Dementia Research (M.D.), Klinikum der Universität München, Ludwig-Maximilians-Universität München, Munich; German Center for Neurodegenerative Diseases (DZNE) and Munich Cluster for Systems Neurology (SyNergy) (M.D.), Germany; Department of Neurosciences, Experimental Neurology and Leuven Research Institute for Neuroscience and Disease (LIND) (R.L.), KU Leuven-University of Leuven; Department of Neurology (R.L.), University Hospitals Leuven; Laboratory of Neurobiology (R.L.), VIB Center for Brain and Disease Research, Leuven, Belgium; Center for Human Genetic Research (J.R.) and Division of Neurocritical Care and Emergency Neurology (J.R.) and J. Philip Kistler Stroke Research Center (J.R., N.S.R.), Department of Neurology, Massachusetts General Hospital, Boston; Nuffield Department of Clinical Neurosciences (Clinical Neurology), Stroke Prevention Research Unit (P.M.R.), University of Oxford; Centre for Clinical Brain Sciences and Institute for Genetics and Molecular Medicine (C.L.M.S.), University of Edinburgh, UK; Stroke Division, Florey Institute of Neuroscience and Mental Health (V.T.), University of Melbourne; and Department of Neurology (V.T.), Austin Health, Heidelberg, Victoria, Australia
| | - Giorgio Boncoraglio
- From the Department of Clinical Neurosciences, Stroke Research Group (M.T., D.J.T., I.D.C., D.M.L.F., A.O.O., L.R.-J., H.S.M.), University of Cambridge, UK; Department of Cerebrovascular Diseases (G.B.), Fondazione IRCCS Istituto Neurologico "Carlo Besta," Milan, Italy; Institute for Stroke and Dementia Research (M.D.), Klinikum der Universität München, Ludwig-Maximilians-Universität München, Munich; German Center for Neurodegenerative Diseases (DZNE) and Munich Cluster for Systems Neurology (SyNergy) (M.D.), Germany; Department of Neurosciences, Experimental Neurology and Leuven Research Institute for Neuroscience and Disease (LIND) (R.L.), KU Leuven-University of Leuven; Department of Neurology (R.L.), University Hospitals Leuven; Laboratory of Neurobiology (R.L.), VIB Center for Brain and Disease Research, Leuven, Belgium; Center for Human Genetic Research (J.R.) and Division of Neurocritical Care and Emergency Neurology (J.R.) and J. Philip Kistler Stroke Research Center (J.R., N.S.R.), Department of Neurology, Massachusetts General Hospital, Boston; Nuffield Department of Clinical Neurosciences (Clinical Neurology), Stroke Prevention Research Unit (P.M.R.), University of Oxford; Centre for Clinical Brain Sciences and Institute for Genetics and Molecular Medicine (C.L.M.S.), University of Edinburgh, UK; Stroke Division, Florey Institute of Neuroscience and Mental Health (V.T.), University of Melbourne; and Department of Neurology (V.T.), Austin Health, Heidelberg, Victoria, Australia
| | - Martin Dichgans
- From the Department of Clinical Neurosciences, Stroke Research Group (M.T., D.J.T., I.D.C., D.M.L.F., A.O.O., L.R.-J., H.S.M.), University of Cambridge, UK; Department of Cerebrovascular Diseases (G.B.), Fondazione IRCCS Istituto Neurologico "Carlo Besta," Milan, Italy; Institute for Stroke and Dementia Research (M.D.), Klinikum der Universität München, Ludwig-Maximilians-Universität München, Munich; German Center for Neurodegenerative Diseases (DZNE) and Munich Cluster for Systems Neurology (SyNergy) (M.D.), Germany; Department of Neurosciences, Experimental Neurology and Leuven Research Institute for Neuroscience and Disease (LIND) (R.L.), KU Leuven-University of Leuven; Department of Neurology (R.L.), University Hospitals Leuven; Laboratory of Neurobiology (R.L.), VIB Center for Brain and Disease Research, Leuven, Belgium; Center for Human Genetic Research (J.R.) and Division of Neurocritical Care and Emergency Neurology (J.R.) and J. Philip Kistler Stroke Research Center (J.R., N.S.R.), Department of Neurology, Massachusetts General Hospital, Boston; Nuffield Department of Clinical Neurosciences (Clinical Neurology), Stroke Prevention Research Unit (P.M.R.), University of Oxford; Centre for Clinical Brain Sciences and Institute for Genetics and Molecular Medicine (C.L.M.S.), University of Edinburgh, UK; Stroke Division, Florey Institute of Neuroscience and Mental Health (V.T.), University of Melbourne; and Department of Neurology (V.T.), Austin Health, Heidelberg, Victoria, Australia
| | - Robin Lemmens
- From the Department of Clinical Neurosciences, Stroke Research Group (M.T., D.J.T., I.D.C., D.M.L.F., A.O.O., L.R.-J., H.S.M.), University of Cambridge, UK; Department of Cerebrovascular Diseases (G.B.), Fondazione IRCCS Istituto Neurologico "Carlo Besta," Milan, Italy; Institute for Stroke and Dementia Research (M.D.), Klinikum der Universität München, Ludwig-Maximilians-Universität München, Munich; German Center for Neurodegenerative Diseases (DZNE) and Munich Cluster for Systems Neurology (SyNergy) (M.D.), Germany; Department of Neurosciences, Experimental Neurology and Leuven Research Institute for Neuroscience and Disease (LIND) (R.L.), KU Leuven-University of Leuven; Department of Neurology (R.L.), University Hospitals Leuven; Laboratory of Neurobiology (R.L.), VIB Center for Brain and Disease Research, Leuven, Belgium; Center for Human Genetic Research (J.R.) and Division of Neurocritical Care and Emergency Neurology (J.R.) and J. Philip Kistler Stroke Research Center (J.R., N.S.R.), Department of Neurology, Massachusetts General Hospital, Boston; Nuffield Department of Clinical Neurosciences (Clinical Neurology), Stroke Prevention Research Unit (P.M.R.), University of Oxford; Centre for Clinical Brain Sciences and Institute for Genetics and Molecular Medicine (C.L.M.S.), University of Edinburgh, UK; Stroke Division, Florey Institute of Neuroscience and Mental Health (V.T.), University of Melbourne; and Department of Neurology (V.T.), Austin Health, Heidelberg, Victoria, Australia
| | - Jonathan Rosand
- From the Department of Clinical Neurosciences, Stroke Research Group (M.T., D.J.T., I.D.C., D.M.L.F., A.O.O., L.R.-J., H.S.M.), University of Cambridge, UK; Department of Cerebrovascular Diseases (G.B.), Fondazione IRCCS Istituto Neurologico "Carlo Besta," Milan, Italy; Institute for Stroke and Dementia Research (M.D.), Klinikum der Universität München, Ludwig-Maximilians-Universität München, Munich; German Center for Neurodegenerative Diseases (DZNE) and Munich Cluster for Systems Neurology (SyNergy) (M.D.), Germany; Department of Neurosciences, Experimental Neurology and Leuven Research Institute for Neuroscience and Disease (LIND) (R.L.), KU Leuven-University of Leuven; Department of Neurology (R.L.), University Hospitals Leuven; Laboratory of Neurobiology (R.L.), VIB Center for Brain and Disease Research, Leuven, Belgium; Center for Human Genetic Research (J.R.) and Division of Neurocritical Care and Emergency Neurology (J.R.) and J. Philip Kistler Stroke Research Center (J.R., N.S.R.), Department of Neurology, Massachusetts General Hospital, Boston; Nuffield Department of Clinical Neurosciences (Clinical Neurology), Stroke Prevention Research Unit (P.M.R.), University of Oxford; Centre for Clinical Brain Sciences and Institute for Genetics and Molecular Medicine (C.L.M.S.), University of Edinburgh, UK; Stroke Division, Florey Institute of Neuroscience and Mental Health (V.T.), University of Melbourne; and Department of Neurology (V.T.), Austin Health, Heidelberg, Victoria, Australia
| | - Natalia S Rost
- From the Department of Clinical Neurosciences, Stroke Research Group (M.T., D.J.T., I.D.C., D.M.L.F., A.O.O., L.R.-J., H.S.M.), University of Cambridge, UK; Department of Cerebrovascular Diseases (G.B.), Fondazione IRCCS Istituto Neurologico "Carlo Besta," Milan, Italy; Institute for Stroke and Dementia Research (M.D.), Klinikum der Universität München, Ludwig-Maximilians-Universität München, Munich; German Center for Neurodegenerative Diseases (DZNE) and Munich Cluster for Systems Neurology (SyNergy) (M.D.), Germany; Department of Neurosciences, Experimental Neurology and Leuven Research Institute for Neuroscience and Disease (LIND) (R.L.), KU Leuven-University of Leuven; Department of Neurology (R.L.), University Hospitals Leuven; Laboratory of Neurobiology (R.L.), VIB Center for Brain and Disease Research, Leuven, Belgium; Center for Human Genetic Research (J.R.) and Division of Neurocritical Care and Emergency Neurology (J.R.) and J. Philip Kistler Stroke Research Center (J.R., N.S.R.), Department of Neurology, Massachusetts General Hospital, Boston; Nuffield Department of Clinical Neurosciences (Clinical Neurology), Stroke Prevention Research Unit (P.M.R.), University of Oxford; Centre for Clinical Brain Sciences and Institute for Genetics and Molecular Medicine (C.L.M.S.), University of Edinburgh, UK; Stroke Division, Florey Institute of Neuroscience and Mental Health (V.T.), University of Melbourne; and Department of Neurology (V.T.), Austin Health, Heidelberg, Victoria, Australia
| | - Peter M Rothwell
- From the Department of Clinical Neurosciences, Stroke Research Group (M.T., D.J.T., I.D.C., D.M.L.F., A.O.O., L.R.-J., H.S.M.), University of Cambridge, UK; Department of Cerebrovascular Diseases (G.B.), Fondazione IRCCS Istituto Neurologico "Carlo Besta," Milan, Italy; Institute for Stroke and Dementia Research (M.D.), Klinikum der Universität München, Ludwig-Maximilians-Universität München, Munich; German Center for Neurodegenerative Diseases (DZNE) and Munich Cluster for Systems Neurology (SyNergy) (M.D.), Germany; Department of Neurosciences, Experimental Neurology and Leuven Research Institute for Neuroscience and Disease (LIND) (R.L.), KU Leuven-University of Leuven; Department of Neurology (R.L.), University Hospitals Leuven; Laboratory of Neurobiology (R.L.), VIB Center for Brain and Disease Research, Leuven, Belgium; Center for Human Genetic Research (J.R.) and Division of Neurocritical Care and Emergency Neurology (J.R.) and J. Philip Kistler Stroke Research Center (J.R., N.S.R.), Department of Neurology, Massachusetts General Hospital, Boston; Nuffield Department of Clinical Neurosciences (Clinical Neurology), Stroke Prevention Research Unit (P.M.R.), University of Oxford; Centre for Clinical Brain Sciences and Institute for Genetics and Molecular Medicine (C.L.M.S.), University of Edinburgh, UK; Stroke Division, Florey Institute of Neuroscience and Mental Health (V.T.), University of Melbourne; and Department of Neurology (V.T.), Austin Health, Heidelberg, Victoria, Australia
| | - Cathie L M Sudlow
- From the Department of Clinical Neurosciences, Stroke Research Group (M.T., D.J.T., I.D.C., D.M.L.F., A.O.O., L.R.-J., H.S.M.), University of Cambridge, UK; Department of Cerebrovascular Diseases (G.B.), Fondazione IRCCS Istituto Neurologico "Carlo Besta," Milan, Italy; Institute for Stroke and Dementia Research (M.D.), Klinikum der Universität München, Ludwig-Maximilians-Universität München, Munich; German Center for Neurodegenerative Diseases (DZNE) and Munich Cluster for Systems Neurology (SyNergy) (M.D.), Germany; Department of Neurosciences, Experimental Neurology and Leuven Research Institute for Neuroscience and Disease (LIND) (R.L.), KU Leuven-University of Leuven; Department of Neurology (R.L.), University Hospitals Leuven; Laboratory of Neurobiology (R.L.), VIB Center for Brain and Disease Research, Leuven, Belgium; Center for Human Genetic Research (J.R.) and Division of Neurocritical Care and Emergency Neurology (J.R.) and J. Philip Kistler Stroke Research Center (J.R., N.S.R.), Department of Neurology, Massachusetts General Hospital, Boston; Nuffield Department of Clinical Neurosciences (Clinical Neurology), Stroke Prevention Research Unit (P.M.R.), University of Oxford; Centre for Clinical Brain Sciences and Institute for Genetics and Molecular Medicine (C.L.M.S.), University of Edinburgh, UK; Stroke Division, Florey Institute of Neuroscience and Mental Health (V.T.), University of Melbourne; and Department of Neurology (V.T.), Austin Health, Heidelberg, Victoria, Australia
| | - Vincent Thijs
- From the Department of Clinical Neurosciences, Stroke Research Group (M.T., D.J.T., I.D.C., D.M.L.F., A.O.O., L.R.-J., H.S.M.), University of Cambridge, UK; Department of Cerebrovascular Diseases (G.B.), Fondazione IRCCS Istituto Neurologico "Carlo Besta," Milan, Italy; Institute for Stroke and Dementia Research (M.D.), Klinikum der Universität München, Ludwig-Maximilians-Universität München, Munich; German Center for Neurodegenerative Diseases (DZNE) and Munich Cluster for Systems Neurology (SyNergy) (M.D.), Germany; Department of Neurosciences, Experimental Neurology and Leuven Research Institute for Neuroscience and Disease (LIND) (R.L.), KU Leuven-University of Leuven; Department of Neurology (R.L.), University Hospitals Leuven; Laboratory of Neurobiology (R.L.), VIB Center for Brain and Disease Research, Leuven, Belgium; Center for Human Genetic Research (J.R.) and Division of Neurocritical Care and Emergency Neurology (J.R.) and J. Philip Kistler Stroke Research Center (J.R., N.S.R.), Department of Neurology, Massachusetts General Hospital, Boston; Nuffield Department of Clinical Neurosciences (Clinical Neurology), Stroke Prevention Research Unit (P.M.R.), University of Oxford; Centre for Clinical Brain Sciences and Institute for Genetics and Molecular Medicine (C.L.M.S.), University of Edinburgh, UK; Stroke Division, Florey Institute of Neuroscience and Mental Health (V.T.), University of Melbourne; and Department of Neurology (V.T.), Austin Health, Heidelberg, Victoria, Australia
| | - Loes Rutten-Jacobs
- From the Department of Clinical Neurosciences, Stroke Research Group (M.T., D.J.T., I.D.C., D.M.L.F., A.O.O., L.R.-J., H.S.M.), University of Cambridge, UK; Department of Cerebrovascular Diseases (G.B.), Fondazione IRCCS Istituto Neurologico "Carlo Besta," Milan, Italy; Institute for Stroke and Dementia Research (M.D.), Klinikum der Universität München, Ludwig-Maximilians-Universität München, Munich; German Center for Neurodegenerative Diseases (DZNE) and Munich Cluster for Systems Neurology (SyNergy) (M.D.), Germany; Department of Neurosciences, Experimental Neurology and Leuven Research Institute for Neuroscience and Disease (LIND) (R.L.), KU Leuven-University of Leuven; Department of Neurology (R.L.), University Hospitals Leuven; Laboratory of Neurobiology (R.L.), VIB Center for Brain and Disease Research, Leuven, Belgium; Center for Human Genetic Research (J.R.) and Division of Neurocritical Care and Emergency Neurology (J.R.) and J. Philip Kistler Stroke Research Center (J.R., N.S.R.), Department of Neurology, Massachusetts General Hospital, Boston; Nuffield Department of Clinical Neurosciences (Clinical Neurology), Stroke Prevention Research Unit (P.M.R.), University of Oxford; Centre for Clinical Brain Sciences and Institute for Genetics and Molecular Medicine (C.L.M.S.), University of Edinburgh, UK; Stroke Division, Florey Institute of Neuroscience and Mental Health (V.T.), University of Melbourne; and Department of Neurology (V.T.), Austin Health, Heidelberg, Victoria, Australia
| | - Hugh S Markus
- From the Department of Clinical Neurosciences, Stroke Research Group (M.T., D.J.T., I.D.C., D.M.L.F., A.O.O., L.R.-J., H.S.M.), University of Cambridge, UK; Department of Cerebrovascular Diseases (G.B.), Fondazione IRCCS Istituto Neurologico "Carlo Besta," Milan, Italy; Institute for Stroke and Dementia Research (M.D.), Klinikum der Universität München, Ludwig-Maximilians-Universität München, Munich; German Center for Neurodegenerative Diseases (DZNE) and Munich Cluster for Systems Neurology (SyNergy) (M.D.), Germany; Department of Neurosciences, Experimental Neurology and Leuven Research Institute for Neuroscience and Disease (LIND) (R.L.), KU Leuven-University of Leuven; Department of Neurology (R.L.), University Hospitals Leuven; Laboratory of Neurobiology (R.L.), VIB Center for Brain and Disease Research, Leuven, Belgium; Center for Human Genetic Research (J.R.) and Division of Neurocritical Care and Emergency Neurology (J.R.) and J. Philip Kistler Stroke Research Center (J.R., N.S.R.), Department of Neurology, Massachusetts General Hospital, Boston; Nuffield Department of Clinical Neurosciences (Clinical Neurology), Stroke Prevention Research Unit (P.M.R.), University of Oxford; Centre for Clinical Brain Sciences and Institute for Genetics and Molecular Medicine (C.L.M.S.), University of Edinburgh, UK; Stroke Division, Florey Institute of Neuroscience and Mental Health (V.T.), University of Melbourne; and Department of Neurology (V.T.), Austin Health, Heidelberg, Victoria, Australia
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Liu J, Rutten-Jacobs L, Liu M, Markus HS, Traylor M. Causal Impact of Type 2 Diabetes Mellitus on Cerebral Small Vessel Disease: A Mendelian Randomization Analysis. Stroke 2018; 49:1325-1331. [PMID: 29686024 PMCID: PMC5976219 DOI: 10.1161/strokeaha.117.020536] [Citation(s) in RCA: 73] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 03/06/2018] [Accepted: 03/12/2018] [Indexed: 02/05/2023]
Abstract
BACKGROUND AND PURPOSE The relationship between type 2 diabetes mellitus (T2D) and cerebral small vessel disease (CSVD) is unclear. We aimed to examine the causal effect of T2D, fasting glucose levels, and higher insulin resistance on CSVD using Mendelian randomization. METHODS Five CSVD phenotypes were studied; 2 were clinical outcomes associated with CSVD (lacunar stroke: n=2191/27 297 and intracerebral hemorrhage [ICH]: n=2254/8195 [deep and lobar ICH]), whereas 3 were radiological markers of CSVD (white matter hyperintensities: n=8429; fractional anisotropy [FA]: n=8357; and mean diffusivity: n=8357). We applied 2 complementary analyses to evaluate the association of T2D with CSVD. First, we used summarized data from genome-wide association study to calculate the effects of T2D-related variants on CSVD with inverse-variance weighted and weighted median approaches. Second, we performed a genetic risk score approach to test the effects of T2D-associated variants on white matter hyperintensities, FA, and mean diffusivity using individual-level data in UK Biobank. RESULTS T2D was associated with higher risk of lacunar stroke (odds ratio [OR], 1.15; 95% confidence interval [CI], 1.04-1.28; P=0.007) and lower mean FA (OR, 0.78; 95% CI, 0.66-0.92; P=0.004) but not white matter hyperintensities volume (OR, 1.01; 95% CI, 0.97-1.04; P=0.626), higher mean diffusivity (OR, 1.04; 95% CI, 0.89-1.23; P=0.612), ICH (OR, 1.07; 95% CI, 0.95-1.20; P=0.269), lobar ICH (OR, 1.07; 95% CI, 0.89-1.28; P=0.466), or deep ICH (OR, 1.16; 95% CI, 0.99-1.36; P=0.074). Weighted median and penalized median weighted analysis showed similar effect estimates of T2D on lacunar stroke and FA, but with wider CIs, meaning they were not significant. The genetic score on individual-level data was significantly associated with FA (OR, 0.63; 95% CI, 0.45-0.89; P=0.008) after adjusting for potential confounders. CONCLUSIONS Our Mendelian randomization study provides evidence to suggest that T2D may be causally associated with CSVD, in particular with lacunar stroke and FA.
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Affiliation(s)
- Junfeng Liu
- From the Stroke Clinical Research Unit, Department of Neurology, West China Hospital, Sichuan University, Chengdu, P. R. China (J.L., M.L.)
- Department of Clinical Neurosciences, Stroke Research Group, University of Cambridge, United Kingdom (J.L., L.R.-J., H.S.M., M.T.)
| | - Loes Rutten-Jacobs
- Department of Clinical Neurosciences, Stroke Research Group, University of Cambridge, United Kingdom (J.L., L.R.-J., H.S.M., M.T.)
- Population Health Sciences, German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany (L.R.-J.)
| | - Ming Liu
- From the Stroke Clinical Research Unit, Department of Neurology, West China Hospital, Sichuan University, Chengdu, P. R. China (J.L., M.L.)
| | - Hugh S Markus
- Department of Clinical Neurosciences, Stroke Research Group, University of Cambridge, United Kingdom (J.L., L.R.-J., H.S.M., M.T.)
| | - Matthew Traylor
- Department of Clinical Neurosciences, Stroke Research Group, University of Cambridge, United Kingdom (J.L., L.R.-J., H.S.M., M.T.)
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11
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Malik R, Chauhan G, Traylor M, Sargurupremraj M, Okada Y, Mishra A, Rutten-Jacobs L, Giese AK, van der Laan SW, Gretarsdottir S, Anderson CD, Chong M, Adams HHH, Ago T, Almgren P, Amouyel P, Ay H, Bartz TM, Benavente OR, Bevan S, Boncoraglio GB, Brown RD, Butterworth AS, Carrera C, Carty CL, Chasman DI, Chen WM, Cole JW, Correa A, Cotlarciuc I, Cruchaga C, Danesh J, de Bakker PIW, DeStefano AL, den Hoed M, Duan Q, Engelter ST, Falcone GJ, Gottesman RF, Grewal RP, Gudnason V, Gustafsson S, Haessler J, Harris TB, Hassan A, Havulinna AS, Heckbert SR, Holliday EG, Howard G, Hsu FC, Hyacinth HI, Ikram MA, ingelsson E, Irvin MR, Jian X, Jimenez-Conde J, Johnson JA, Jukema JW, Kanai M, Keene KL, Kissela BM, Kleindorfer DO, Kooperberg C, Kubo M, Lange LA, Langefeld CD, Langenberg C, Launer LJ, Lee JM, Lemmens R, Leys D, Lewis CM, Lin WY, Lindgren AG, Lorentzen E, Magnusson PK, Maguire J, Manichaikul A, McArdle PF, Meschia JF, Mitchell BD, Mosley TH, Nalls MA, Ninomiya T, O’Donnell MJ, Psaty BM, Pulit SL, Rannikmäe K, Reiner AP, Rexrode KM, Rice K, Rich SS, Ridker PM, Rost NS, Rothwell PM, Rotter JI, Rundek T, Sacco RL, Sakaue S, Sale MM, Salomaa V, Sapkota BR, Schmidt R, Schmidt CO, Schminke U, Sharma P, Slowik A, Sudlow CLM, Tanislav C, Tatlisumak T, Taylor KD, Thijs VNS, Thorleifsson G, Thorsteinsdottir U, Tiedt S, Trompet S, Tzourio C, van Duijn CM, Walters M, Wareham NJ, Wassertheil-Smoller S, Wilson JG, Wiggins KL, Yang Q, Yusuf S, Bis JC, Pastinen T, Ruusalepp A, Schadt EE, Koplev S, Björkegren JLM, Codoni V, Civelek M, Smith NL, Tregouet DA, Christophersen IE, Roselli C, Lubitz SA, Ellinor PT, Tai ES, Kooner JS, Kato N, He J, van der Harst P, Elliott P, Chambers JC, Takeuchi F, Johnson AD, Sanghera DK, Melander O, Jern C, Strbian D, Fernandez-Cadenas I, Longstreth WT, Rolfs A, Hata J, Woo D, Rosand J, Pare G, Hopewell JC, Saleheen D, Stefansson K, Worrall BB, Kittner SJ, Seshadri S, Fornage M, Markus HS, Howson JMM, Kamatani Y, Debette S, Dichgans M. Multiancestry genome-wide association study of 520,000 subjects identifies 32 loci associated with stroke and stroke subtypes. Nat Genet 2018; 50:524-537. [PMID: 29531354 PMCID: PMC5968830 DOI: 10.1038/s41588-018-0058-3] [Citation(s) in RCA: 879] [Impact Index Per Article: 146.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Accepted: 01/08/2018] [Indexed: 02/02/2023]
Abstract
Stroke has multiple etiologies, but the underlying genes and pathways are largely unknown. We conducted a multiancestry genome-wide-association meta-analysis in 521,612 individuals (67,162 cases and 454,450 controls) and discovered 22 new stroke risk loci, bringing the total to 32. We further found shared genetic variation with related vascular traits, including blood pressure, cardiac traits, and venous thromboembolism, at individual loci (n = 18), and using genetic risk scores and linkage-disequilibrium-score regression. Several loci exhibited distinct association and pleiotropy patterns for etiological stroke subtypes. Eleven new susceptibility loci indicate mechanisms not previously implicated in stroke pathophysiology, with prioritization of risk variants and genes accomplished through bioinformatics analyses using extensive functional datasets. Stroke risk loci were significantly enriched in drug targets for antithrombotic therapy.
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Affiliation(s)
- Rainer Malik
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
| | - Ganesh Chauhan
- Centre for Brain Research, Indian Institute of Science, Bangalore, India,INSERM U1219 Bordeaux Population Health Research Center, University of Bordeaux, France
| | - Matthew Traylor
- Stroke Research Group, Division of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Muralidharan Sargurupremraj
- INSERM U1219 Bordeaux Population Health Research Center, University of Bordeaux, France,Department of Neurology, Institute for Neurodegenerative Disease, Bordeaux University Hospital, Bordeaux, France
| | - Yukinori Okada
- Laboratory of Statistical Immunology, Immunology Frontier Research Center (WPI-IFReC), Osaka University, Suita, Japan,Faculty of Health and Medicine, University of Newcastle, Newcastle, New South Wales, Australia
| | - Aniket Mishra
- INSERM U1219 Bordeaux Population Health Research Center, University of Bordeaux, France,Department of Neurology, Institute for Neurodegenerative Disease, Bordeaux University Hospital, Bordeaux, France
| | - Loes Rutten-Jacobs
- Stroke Research Group, Division of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Anne-Katrin Giese
- Department of Neurology, Massachusetts General Hospital (MGH), Harvard Medical School, Boston, MA, USA
| | - Sander W. van der Laan
- Laboratory of Experimental Cardiology, Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, University of Utrecht, Utrecht, the Netherlands
| | | | - Christopher D. Anderson
- Center for Genomic Medicine, MGH, Boston, MA, USA,J. Philip Kistler Stroke Research Center, Department of Neurology, MGH, Boston, MA, USA,Program in Medical and Population Genetics, Broad Institute, Cambridge, MA, USA
| | - Michael Chong
- Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada
| | - Hieab H. H. Adams
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands,Department of Radiology and Nuclear Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Tetsuro Ago
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Peter Almgren
- Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Philippe Amouyel
- INSERM, Institut Pasteur de Lille, LabEx DISTALZ-UMR1167, Risk Factors and Molecular Determinants of Aging-Related Diseases, Université Lille, Lille, France,Centre Hospitalier Universite Lille, Epidemiology and Public Health Department, Lille, France
| | - Hakan Ay
- J. Philip Kistler Stroke Research Center, Department of Neurology, MGH, Boston, MA, USA,AA Martinos Center for Biomedical Imaging, Department of Radiology, MGH, Harvard Medical School, Boston, MA, USA
| | - Traci M. Bartz
- Cardiovascular Health Research Unit, Departments of Biostatistics and Medicine, University of Washington, Seattle, WA, USA
| | - Oscar R. Benavente
- Division of Neurology, Faculty of Medicine, Brain Research Center, University of British Columbia, Vancouver, British Columbia, Canada
| | - Steve Bevan
- School of Life Science, University of Lincoln, Lincoln, UK
| | - Giorgio B. Boncoraglio
- Department of Cerebrovascular Diseases, Fondazione IRCCS Istituto Neurologico ‘Carlo Besta’, Milan, Italy
| | - Robert D. Brown
- Department of Neurology, Mayo Clinic Rochester, Rochester, MN, USA
| | - Adam S. Butterworth
- MRC/BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK,National Institute for Health Research Blood and Transplant Research Unit in Donor Health and Genomics, University of Cambridge, Cambridge, UK
| | - Caty Carrera
- Neurovascular Research Laboratory, Vall d’Hebron Institut of Research, Neurology and Medicine Departments-Universitat Autònoma de Barcelona, Vall d’Hebrón Hospital, Barcelona, Spain,Stroke Pharmacogenomics and Genetics, Fundacio Docència i Recerca MutuaTerrassa, Terrassa, Spain
| | - Cara L. Carty
- Children’s Research Institute, Children’s National Medical Center, Washington, DC, USA,Center for Translational Science, George Washington University, Washington, DC, USA
| | - Daniel I. Chasman
- Division of Preventive Medicine, Brigham and Women’s Hospital, Boston, MA, USA,Harvard Medical School, Boston, MA, USA
| | - Wei-Min Chen
- Center for Public Health Genomics, Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA
| | - John W. Cole
- Department of Neurology, University of Maryland School of Medicine and Baltimore VAMC, Baltimore, MD, USA
| | - Adolfo Correa
- Departments of Medicine, Pediatrics and Population Health Science, University of Mississippi Medical Center, Jackson, MS, USA
| | - Ioana Cotlarciuc
- Institute of Cardiovascular Research, Royal Holloway University of London, London, UK, and Ashford and St Peters Hospital, Surrey, UK
| | - Carlos Cruchaga
- Department of Psychiatry, Hope Center Program on Protein Aggregation and Neurodegeneration (HPAN), Washington University School of Medicine, St. Louis, MO, USA,Department of Developmental Biology, Washington University School of Medicine, St. Louis, MO, USA
| | - John Danesh
- MRC/BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK,NIHR Blood and Transplant Research Unit in Donor Health and Genomics, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK,Wellcome Trust Sanger Institute, Hinxton, Cambridge, UK,British Heart Foundation, Cambridge Centre of Excellence, Department of Medicine, University of Cambridge, Cambridge, UK
| | - Paul I. W. de Bakker
- Department of Medical Genetics, University Medical Center Utrecht, Utrecht, the Netherlands,Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Anita L. DeStefano
- Boston University School of Public Health, Boston, MA, USA,Framingham Heart Study, Framingham, MA, USA
| | - Marcel den Hoed
- Department of Immunology, Genetics and Pathology and Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Qing Duan
- Department of Genetics, University of North Carolina, Chapel Hill, NC, USA
| | - Stefan T. Engelter
- Department of Neurology and Stroke Center, Basel University Hospital, Basel, Switzerland,Neurorehabilitation Unit, University of Basel and University Center for Medicine of Aging and Rehabilitation Basel, Felix Platter Hospital, Basel, Switzerland
| | - Guido J. Falcone
- Department of Neurology, Yale University School of Medicine, New Haven, CT, USA,Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, MA, USA
| | - Rebecca F. Gottesman
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Raji P. Grewal
- Neuroscience Institute, SF Medical Center, Trenton, NJ, USA
| | - Vilmundur Gudnason
- Icelandic Heart Association Research Institute, Kopavogur, Iceland,Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Stefan Gustafsson
- Department of Medical Sciences, Molecular Epidemiology and Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Jeffrey Haessler
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Tamara B. Harris
- Laboratory of Epidemiology and Population Science, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
| | - Ahamad Hassan
- Department of Neurology, Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Aki S. Havulinna
- National Institute for Health and Welfare, Helsinki, Finland,FIMM-Institute for Molecular Medicine Finland, Helsinki, Finland
| | - Susan R. Heckbert
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Elizabeth G. Holliday
- Public Health Stream, Hunter Medical Research Institute, New Lambton, New South Wales, Australia,Faculty of Health and Medicine, University of Newcastle, Newcastle, New South Wales, Australia
| | - George Howard
- School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Fang-Chi Hsu
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Hyacinth I. Hyacinth
- Aflac Cancer and Blood Disorder Center, Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
| | - M. Arfan Ikram
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Erik ingelsson
- Department of Medicine, Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, CA, USA,Department of Medical Sciences, Molecular Epidemiology and Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Marguerite R. Irvin
- Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Xueqiu Jian
- Brown Foundation Institute of Molecular Medicine, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Jordi Jimenez-Conde
- Neurovascular Research Group (NEUVAS), Neurology Department, Institut Hospital del Mar d’Investigació Mèdica, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Julie A. Johnson
- Department of Pharmacotherapy and Translational Research and Center for Pharmacogenomics, University of Florida, College of Pharmacy, Gainesville, FL, USA,Division of Cardiovascular Medicine, College of Medicine, University of Florida, Gainesville, FL, USA
| | - J. Wouter Jukema
- Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Masahiro Kanai
- Faculty of Health and Medicine, University of Newcastle, Newcastle, New South Wales, Australia,Program in Bioinformatics and Integrative Genomics, Harvard Medical School, Boston, MA, USA
| | - Keith L. Keene
- Department of Biology, East Carolina University, Greenville, NC, USA,Center for Health Disparities, East Carolina University, Greenville, NC, USA
| | - Brett M. Kissela
- University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | | | - Charles Kooperberg
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Michiaki Kubo
- RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | - Leslie A. Lange
- Department of Medicine, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO, USA
| | - Carl D. Langefeld
- Center for Public Health Genomics and Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Claudia Langenberg
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge, UK
| | - Lenore J. Launer
- Intramural Research Program, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
| | - Jin-Moo Lee
- Department of Neurology, Radiology, and Biomedical Engineering, Washington University School of Medicine, St. Louis, MO, USA
| | - Robin Lemmens
- Department of Neurosciences, Experimental Neurology, KU Leuven-University of Leuven, Leuven, Belgium,VIB Center for Brain & Disease Research, University Hospitals Leuven, Department of Neurology, Leuven, Belgium
| | - Didier Leys
- INSERM U 1171, CHU Lille, Universite Lille, Lille, France
| | - Cathryn M. Lewis
- Department of Medical and Molecular Genetics, King’s College London, London, UK,SGDP Centre, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
| | - Wei-Yu Lin
- MRC/BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK,Northern Institute for Cancer Research, Newcastle University, Newcastle, UK
| | - Arne G. Lindgren
- Department of Clinical Sciences Lund, Neurology, Lund University, Lund, Sweden,Department of Neurology and Rehabilitation Medicine, Skåne University Hospital, Lund, Sweden
| | - Erik Lorentzen
- Bioinformatics Core Facility, University of Gothenburg, Gothenburg, Sweden
| | - Patrik K. Magnusson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Jane Maguire
- University of Technology Sydney, Faculty of Health, Ultimo, New South Wales, Australia
| | - Ani Manichaikul
- Center for Public Health Genomics, Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA
| | - Patrick F. McArdle
- Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | | | - Braxton D. Mitchell
- Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA,Geriatrics Research and Education Clinical Center, Baltimore Veterans Administration Medical Center, Baltimore, MD, USA
| | - Thomas H. Mosley
- Division of Geriatrics, School of Medicine, University of Mississippi Medical Center, Jackson, MS, USA,Memory Impairment and Neurodegenerative Dementia Center, University of Mississippi Medical Center, Jackson, MS, USA
| | - Michael A. Nalls
- Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA,Data Tecnica International, Glen Echo, MD, USA
| | - Toshiharu Ninomiya
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Martin J. O’Donnell
- Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada,Clinical Research Facility, Department of Medicine, NUI Galway, Galway, Ireland
| | - Bruce M. Psaty
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, USA,Department of Epidemiology, University of Washington, Seattle, WA, USA,Department of Health Services, University of Washington, Seattle, WA, USA,Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | - Sara L. Pulit
- Department of Medical Genetics, University Medical Center Utrecht, Utrecht, the Netherlands,Brain Center Rudolf Magnus, Department of Neurology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Kristiina Rannikmäe
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK,Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Alexander P. Reiner
- Department of Epidemiology, University of Washington, Seattle, WA, USA,Fred Hutchinson Cancer Research Center, University of Washington, Seattle, WA, USA
| | | | - Kenneth Rice
- Department of Biostatistics, University of Washington, Seattle, WA, USA
| | - Stephen S. Rich
- Center for Public Health Genomics, Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA
| | - Paul M. Ridker
- Division of Preventive Medicine, Brigham and Women’s Hospital, Boston, MA, USA,Harvard Medical School, Boston, MA, USA
| | - Natalia S. Rost
- Department of Neurology, Massachusetts General Hospital (MGH), Harvard Medical School, Boston, MA, USA,J. Philip Kistler Stroke Research Center, Department of Neurology, MGH, Boston, MA, USA
| | - Peter M. Rothwell
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Jerome I. Rotter
- Institute for Translational Genomics and Population Sciences, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA,Division of Genomic Outcomes, Department of Pediatrics, Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Tatjana Rundek
- Department of Neurology, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Ralph L. Sacco
- Department of Neurology, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Saori Sakaue
- Department of Statistical Genetics, Osaka University Graduate School of Medicine, Osaka, Japan,Department of Allergy and Rheumatology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Michele M. Sale
- Center for Public Health Genomics, University of Virginia, Charlottesville, VA, USA
| | - Veikko Salomaa
- National Institute for Health and Welfare, Helsinki, Finland
| | - Bishwa R. Sapkota
- Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Reinhold Schmidt
- Department of Neurology, Medical University of Graz, Graz, Austria
| | - Carsten O. Schmidt
- Institute for Community Medicine, SHIP-KEF, University Medicine Greifswald, Greifswald, Germany
| | - Ulf Schminke
- Department of Neurology, University Medicine Greifswald, Greifswald, Germany
| | - Pankaj Sharma
- Institute of Cardiovascular Research, Royal Holloway University of London, London, UK, and Ashford and St Peters Hospital, Surrey, UK
| | - Agnieszka Slowik
- Department of Neurology, Jagiellonian University, Krakow, Poland
| | - Cathie L. M. Sudlow
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK,Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | | | - Turgut Tatlisumak
- Department of Clinical Neurosciences/Neurology, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden,Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Kent D. Taylor
- Institute for Translational Genomics and Population Sciences, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA,Division of Genomic Outcomes, Department of Pediatrics, Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Vincent N. S. Thijs
- Stroke Division, Florey Institute of Neuroscience and Mental Health, University of Melbourne, Heidelberg, Victoria, Australia,Austin Health, Department of Neurology, Heidelberg, Victoria, Australia
| | | | | | - Steffen Tiedt
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
| | - Stella Trompet
- Department of Internal Medicine, Section Gerontology and Geriatrics, Leiden University Medical Center, Leiden, the Netherlands
| | - Christophe Tzourio
- INSERM U1219 Bordeaux Population Health Research Center, University of Bordeaux, France,INSERM, U1219 Bordeaux, France,Department of Public Health, Bordeaux University Hospital, Bordeaux, France
| | - Cornelia M. van Duijn
- Genetic Epidemiology Unit, Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands,Center for Medical Systems Biology, Leiden, the Netherlands
| | - Matthew Walters
- School of Medicine, Dentistry and Nursing at the University of Glasgow, Glasgow, UK
| | - Nicholas J. Wareham
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge, UK
| | - Sylvia Wassertheil-Smoller
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, New York, NY, USA
| | - James G. Wilson
- Department of Physiology and Biophysics, University of Mississippi Medical Center, Jackson, MS, USA
| | - Kerri L. Wiggins
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, USA
| | - Qiong Yang
- Boston University School of Public Health, Boston, MA, USA
| | - Salim Yusuf
- Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada
| | - AFGen Consortium
- A list of members and affiliations appears in the Supplementary Note
| | | | | | - INVENT Consortium
- A list of members and affiliations appears in the Supplementary Note
| | - STARNET
- A list of members and affiliations appears in the Supplementary Note
| | - Joshua C. Bis
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, USA
| | - Tomi Pastinen
- Department of Human Genetics, McGill University, Montreal, Quebec, Canada
| | - Arno Ruusalepp
- Department of Pathophysiology, Institute of Biomedicine and Translation Medicine, University of Tartu, Tartu, Estonia,Department of Cardiac Surgery, Tartu University Hospital, Tartu, Estonia,Clinical Gene Networks AB, Stockholm, Sweden
| | - Eric E. Schadt
- Department of Genetics and Genomic Sciences, Icahn Institute for Genomics and Multiscale Biology Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Simon Koplev
- Department of Genetics and Genomic Sciences, Icahn Institute for Genomics and Multiscale Biology Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Johan L. M. Björkegren
- Department of Genetics and Genomic Sciences, Icahn Institute for Genomics and Multiscale Biology Icahn School of Medicine at Mount Sinai, New York, NY, USA,Department of Pathophysiology, Institute of Biomedicine and Translation Medicine, Biomeedikum, University of Tartu, Tartu, Estonia,Integrated Cardio Metabolic Centre, Department of Medicine, Karolinska Institutet, Karolinska Universitetssjukhuset, Huddinge, Sweden,Clinical Gene Networks AB, Stockholm, Sweden
| | - Veronica Codoni
- UPMC Univ. Paris 06, INSERM, UMR_S 1166, Team Genomics & Pathophysiology of Cardiovascular Diseases, Sorbonne Universités, Paris, France,I CAN Institute for Cardiometabolism and Nutrition, Paris, France
| | - Mete Civelek
- Center for Public Health Genomics, University of Virginia, Charlottesville, VA, USA,Department of Biomedical Engineering, University of Virginia, Charlottesville, VA, USA
| | - Nicholas L. Smith
- Department of Epidemiology, University of Washington, Seattle, WA, USA,Group Health Research Institute, Group Health Cooperative, Seattle, WA, USA,Seattle Epidemiologic Research and Information Center, VA Office of Research and Development, Seattle, WA, USA
| | - David A. Tregouet
- UPMC Univ. Paris 06, INSERM, UMR_S 1166, Team Genomics & Pathophysiology of Cardiovascular Diseases, Sorbonne Universités, Paris, France,I CAN Institute for Cardiometabolism and Nutrition, Paris, France
| | - Ingrid E. Christophersen
- Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, MA, USA,Cardiovascular Research Center, MGH, Boston, MA, USA,Department of Medical Research, Bærum Hospital, Vestre Viken Hospital Trust, Gjettum, Norway
| | - Carolina Roselli
- Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, MA, USA
| | - Steven A. Lubitz
- Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, MA, USA,Cardiovascular Research Center, MGH, Boston, MA, USA
| | - Patrick T. Ellinor
- Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, MA, USA,Cardiovascular Research Center, MGH, Boston, MA, USA
| | - E. Shyong Tai
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Jaspal S. Kooner
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Norihiro Kato
- Department of Gene Diagnostics and Therapeutics, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan
| | - Jiang He
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Pim van der Harst
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Paul Elliott
- MRC-PHE Centre for Environment and Health, School of Public Health, Department of Epidemiology and Biostatistics and the NIHR Imperial Biomedical Research Centre, Imperial College London, London, UK
| | - John C. Chambers
- Department of Epidemiology and Biostatistics, Imperial College London, London, UK,Department of Cardiology, Ealing Hospital NHS Trust, Southall, UK
| | - Fumihiko Takeuchi
- Department of Gene Diagnostics and Therapeutics, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan
| | - Andrew D. Johnson
- Framingham Heart Study, Framingham, MA, USA,National Heart, Lung and Blood Research Institute, Division of Intramural Research, Population Sciences Branch, Framingham, MA, USA
| | | | | | | | | | | | | | | | | | | | | | - Dharambir K. Sanghera
- Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA,Department of Pharmaceutical Sciences, College of Pharmacy, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA,Oklahoma Center for Neuroscience, Oklahoma City, OK, USA
| | - Olle Melander
- Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Christina Jern
- Department of Pathology and Genetics, Institute of Biomedicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Daniel Strbian
- Department of Neurology, Helsinki University Hospital, Helsinki, Finland,Clinical Neurosciences, Neurology, University of Helsinki, Helsinki, Finland
| | - Israel Fernandez-Cadenas
- Neurovascular Research Laboratory, Vall d’Hebron Institut of Research, Neurology and Medicine Departments-Universitat Autònoma de Barcelona, Vall d’Hebrón Hospital, Barcelona, Spain,Stroke Pharmacogenomics and Genetics, Fundacio Docència i Recerca MutuaTerrassa, Terrassa, Spain
| | - W. T. Longstreth
- Department of Epidemiology, University of Washington, Seattle, WA, USA,Department of Neurology, University of Washington, Seattle, WA, USA
| | - Arndt Rolfs
- Albrecht Kossel Institute, University Clinic of Rostock, Rostock, Germany
| | - Jun Hata
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Daniel Woo
- University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Jonathan Rosand
- Center for Genomic Medicine, MGH, Boston, MA, USA,J. Philip Kistler Stroke Research Center, Department of Neurology, MGH, Boston, MA, USA,Program in Medical and Population Genetics, Broad Institute, Cambridge, MA, USA
| | - Guillaume Pare
- Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada
| | - Jemma C. Hopewell
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Danish Saleheen
- Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Kari Stefansson
- deCODE genetics/AMGEN Inc., Reykjavik, Iceland,Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Bradford B. Worrall
- Departments of Neurology and Public Health Sciences, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Steven J. Kittner
- Department of Neurology, University of Maryland School of Medicine and Baltimore VAMC, Baltimore, MD, USA
| | - Sudha Seshadri
- Framingham Heart Study, Framingham, MA, USA,Glenn Biggs Institute for Alzheimer’s and Neurodegenerative Diseases, University of Texas Health Sciences Center, San Antonio, San Antonio, TX, USA
| | - Myriam Fornage
- Brown Foundation Institute of Molecular Medicine, University of Texas Health Science Center at Houston, Houston, TX, USA,Human Genetics Center, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Hugh S. Markus
- Stroke Research Group, Division of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Joanna M. M. Howson
- MRC/BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Yoichiro Kamatani
- Laboratory for Statistical Analysis, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan,Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Stephanie Debette
- Stroke Research Group, Division of Clinical Neurosciences, University of Cambridge, Cambridge, UK. .,Department of Neurology, Institute for Neurodegenerative Disease, Bordeaux University Hospital, Bordeaux, France.
| | - Martin Dichgans
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany. .,Munich Cluster for Systems Neurology (SyNergy), Munich, Germany. .,German Center for Neurodegenerative Diseases (DZNE), Munich, Germany.
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12
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Traylor M, Rutten-Jacobs L, Curtis C, Patel H, Breen G, Newhouse S, Lewis CM, Markus HS. Genetics of stroke in a UK African ancestry case-control study: South London Ethnicity and Stroke Study. Neurol Genet 2017; 3:e142. [PMID: 28349126 PMCID: PMC5354108 DOI: 10.1212/nxg.0000000000000142] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Accepted: 02/06/2017] [Indexed: 01/18/2023]
Abstract
Objective: Despite epidemiologic data showing an increased stroke incidence in African ancestry populations, genetic studies in this group have so far been limited, and there has been little characterization of the genetic contribution to stroke liability in this population, particularly for stroke subtypes. Methods: We evaluated the evidence that genetic factors contribute to stroke and stroke subtypes in a population of 917 African and African Caribbean stroke cases and 868 matched controls from London, United Kingdom. We (1) estimated the heritability of stroke in this population using genomic-relatedness matrix-restricted maximum likelihood approaches, (2) assessed loci associated with stroke in Europeans in our population, and (3) evaluated the influence of genetic factors underlying cardiovascular risk factors on stroke using polygenic risk scoring. Results: Our results indicate a substantial genetic contribution to stroke risk in African ancestry populations (h2 = 0.35 [SE = 0.19], p = 0.043). Polygenic risk scores indicate that cardiovascular risk scores contribute to the genetic liability (odds ratio [OR] 1.09 [95% confidence interval (CI) 1.01–1.17], p = 0.029) and point to a strong influence of type 2 diabetes in large vessel stroke (OR 1.62 [95% CI 1.19–2.22], p = 0.0024). Single nucleotide polymorphisms associated with ischemic stroke in Europeans shared direction of effect in SLESS (p = 0.031), suggesting that disease mechanisms are shared across ancestries. Conclusions: Stroke in African ancestry populations is highly heritable and influenced by genetic determinants underlying cardiovascular risk factors. In addition, stroke loci identified in Europeans share direction of effect in African populations. Future genome-wide association studies must focus on incorporating African ancestry individuals.
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Affiliation(s)
- Matthew Traylor
- Department of Medical and Molecular Genetics (M.T., C.M.L.), King's College London, Guy's Hospital; Stroke Research Group (M.T., L.R.-J., H.S.M.), Department of Clinical Neurosciences, University of Cambridge, Cambridge Biomedical Campus; and SGDP Centre (C.C., H.P., G.B., S.N., C.M.L.), Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Loes Rutten-Jacobs
- Department of Medical and Molecular Genetics (M.T., C.M.L.), King's College London, Guy's Hospital; Stroke Research Group (M.T., L.R.-J., H.S.M.), Department of Clinical Neurosciences, University of Cambridge, Cambridge Biomedical Campus; and SGDP Centre (C.C., H.P., G.B., S.N., C.M.L.), Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Charles Curtis
- Department of Medical and Molecular Genetics (M.T., C.M.L.), King's College London, Guy's Hospital; Stroke Research Group (M.T., L.R.-J., H.S.M.), Department of Clinical Neurosciences, University of Cambridge, Cambridge Biomedical Campus; and SGDP Centre (C.C., H.P., G.B., S.N., C.M.L.), Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Hamel Patel
- Department of Medical and Molecular Genetics (M.T., C.M.L.), King's College London, Guy's Hospital; Stroke Research Group (M.T., L.R.-J., H.S.M.), Department of Clinical Neurosciences, University of Cambridge, Cambridge Biomedical Campus; and SGDP Centre (C.C., H.P., G.B., S.N., C.M.L.), Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Gerome Breen
- Department of Medical and Molecular Genetics (M.T., C.M.L.), King's College London, Guy's Hospital; Stroke Research Group (M.T., L.R.-J., H.S.M.), Department of Clinical Neurosciences, University of Cambridge, Cambridge Biomedical Campus; and SGDP Centre (C.C., H.P., G.B., S.N., C.M.L.), Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Stephen Newhouse
- Department of Medical and Molecular Genetics (M.T., C.M.L.), King's College London, Guy's Hospital; Stroke Research Group (M.T., L.R.-J., H.S.M.), Department of Clinical Neurosciences, University of Cambridge, Cambridge Biomedical Campus; and SGDP Centre (C.C., H.P., G.B., S.N., C.M.L.), Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Cathryn M Lewis
- Department of Medical and Molecular Genetics (M.T., C.M.L.), King's College London, Guy's Hospital; Stroke Research Group (M.T., L.R.-J., H.S.M.), Department of Clinical Neurosciences, University of Cambridge, Cambridge Biomedical Campus; and SGDP Centre (C.C., H.P., G.B., S.N., C.M.L.), Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Hugh S Markus
- Department of Medical and Molecular Genetics (M.T., C.M.L.), King's College London, Guy's Hospital; Stroke Research Group (M.T., L.R.-J., H.S.M.), Department of Clinical Neurosciences, University of Cambridge, Cambridge Biomedical Campus; and SGDP Centre (C.C., H.P., G.B., S.N., C.M.L.), Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
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13
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Yesilot Barlas N, Putaala J, Waje-Andreassen U, Vassilopoulou S, Nardi K, Odier C, Hofgart G, Engelter S, Burow A, Mihalka L, Kloss M, Ferrari J, Lemmens R, Coban O, Haapaniemi E, Maaijwee N, Rutten-Jacobs L, Bersano A, Cereda C, Baron P, Borellini L, Valcarenghi C, Thomassen L, Grau AJ, Palm F, Urbanek C, Tuncay R, Durukan Tolvanen A, van Dijk EJ, de Leeuw FE, Thijs V, Greisenegger S, Vemmos K, Lichy C, Bereczki D, Csiba L, Michel P, Leys D, Spengos K, Naess H, Tatlisumak T, Bahar SZ. Etiology of first-ever ischaemic stroke in European young adults: the 15 cities young stroke study. Eur J Neurol 2013; 20:1431-9. [PMID: 23837733 DOI: 10.1111/ene.12228] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2013] [Accepted: 06/05/2013] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND PURPOSE Risk factors for IS in young adults differ between genders and evolve with age, but data on the age- and gender-specific differences by stroke etiology are scare. These features were compared based on individual patient data from 15 European stroke centers. METHODS Stroke etiology was reported in detail for 3331 patients aged 15-49 years with first-ever IS according to Trial of Org in Acute Stroke Treatment (TOAST) criteria: large-artery atherosclerosis (LAA), cardioembolism (CE), small-vessel occlusion (SVO), other determined etiology, or undetermined etiology. CE was categorized into low- and high-risk sources. Other determined group was divided into dissection and other non-dissection causes. Comparisons were done using logistic regression, adjusting for age, gender, and center heterogeneity. RESULTS Etiology remained undetermined in 39.6%. Other determined etiology was found in 21.6%, CE in 17.3%, SVO in 12.2%, and LAA in 9.3%. Other determined etiology was more common in females and younger patients, with cervical artery dissection being the single most common etiology (12.8%). CE was more common in younger patients. Within CE, the most frequent high-risk sources were atrial fibrillation/flutter (15.1%) and cardiomyopathy (11.5%). LAA, high-risk sources of CE, and SVO were more common in males. LAA and SVO showed an increasing frequency with age. No significant etiologic distribution differences were found amongst southern, central, or northern Europe. CONCLUSIONS The etiology of IS in young adults has clear gender-specific patterns that change with age. A notable portion of these patients remains without an evident stroke mechanism according to TOAST criteria.
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Affiliation(s)
- N Yesilot Barlas
- Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
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14
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Arntz R, Rutten-Jacobs L, Maaijwee N, Schoonderwaldt H, Dorresteijn L, van Dijk E, de Leeuw FE. Post-stroke epilepsy in young adults: a long-term follow-up study. PLoS One 2013; 8:e55498. [PMID: 23390537 PMCID: PMC3563638 DOI: 10.1371/journal.pone.0055498] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2012] [Accepted: 12/23/2012] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Little is known about the incidence and risk of seizures after stroke in young adults. Especially in the young seizures might dramatically influence prognosis and quality of life. We therefore investigated the long-term incidence and risk of post-stroke epilepsy in young adults with a transient ischemic attack (TIA), ischemic stroke (IS) or intracerebral hemorrhage (ICH). METHODS AND FINDINGS We performed a prospective cohort study among 697 consecutive patients with a first-ever TIA, IS or ICH, aged 18-50 years, admitted to our hospital between 1-1-1980 till 1-11-2010. The occurrence of epilepsy was assessed by standardized questionnaires and verified by a neurologist. Cumulative risks were estimated with Kaplan-Meier analysis. Cox proportional hazard models were used to calculate relative risks. After mean follow-up of 9.1 years (SD 8.2), 79 (11.3%) patients developed post-stroke epilepsy and 39 patients (5.6%) developed epilepsy with recurrent seizures. Patients with an initial late seizure more often developed recurrent seizures than patients with an initial early seizure. Cumulative risk of epilepsy was 31%, 16% and 5% for patients with an ICH, IS and TIA respectively (Logrank test ICH and IS versus TIA p<0.001). Cumulative risk of epilepsy with recurrent seizures was 23%, 8% and 4% respectively (Logrank ICH versus IS p = 0.05, ICH versus TIA p<0.001, IS versus TIA p = 0.01). In addition a high NIHSS was a significant predictor of both epilepsy and epilepsy with recurrent seizures (HR 1.07, 95% CI 1.03-1.11 and 1.08, 95% CI 1.02-1.14). CONCLUSIONS Post-stroke epilepsy is much more common than previously thought. Especially patients with an ICH and a high NIHSS are at high risk. This calls upon the question whether a subgroup could be identified which benefits from the use of prophylactic antiepileptic medication. Future studies should be executed to investigate risk factors and the effect of post-stroke epilepsy on quality of life.
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Affiliation(s)
- Renate Arntz
- Department of Neurology, Radboud University Nijmegen Medical Centre, Donders Institute for Brain, Cognition and Behaviour, The Netherlands
| | - Loes Rutten-Jacobs
- Department of Neurology, Radboud University Nijmegen Medical Centre, Donders Institute for Brain, Cognition and Behaviour, The Netherlands
| | - Noortje Maaijwee
- Department of Neurology, Radboud University Nijmegen Medical Centre, Donders Institute for Brain, Cognition and Behaviour, The Netherlands
| | - Hennie Schoonderwaldt
- Department of Neurology, Radboud University Nijmegen Medical Centre, Donders Institute for Brain, Cognition and Behaviour, The Netherlands
| | | | - Ewoud van Dijk
- Department of Neurology, Radboud University Nijmegen Medical Centre, Donders Institute for Brain, Cognition and Behaviour, The Netherlands
| | - Frank-Erik de Leeuw
- Department of Neurology, Radboud University Nijmegen Medical Centre, Donders Institute for Brain, Cognition and Behaviour, The Netherlands
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15
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Putaala J, Yesilot N, Waje-Andreassen U, Pitkäniemi J, Vassilopoulou S, Nardi K, Odier C, Hofgart G, Engelter S, Burow A, Mihalka L, Kloss M, Ferrari J, Lemmens R, Coban O, Haapaniemi E, Maaijwee N, Rutten-Jacobs L, Bersano A, Cereda C, Baron P, Borellini L, Valcarenghi C, Thomassen L, Grau AJ, Palm F, Urbanek C, Tuncay R, Durukan-Tolvanen A, van Dijk EJ, de Leeuw FE, Thijs V, Greisenegger S, Vemmos K, Lichy C, Bereczki D, Csiba L, Michel P, Leys D, Spengos K, Naess H, Bahar SZ, Tatlisumak T. Demographic and geographic vascular risk factor differences in European young adults with ischemic stroke: the 15 cities young stroke study. Stroke 2012; 43:2624-30. [PMID: 22798330 DOI: 10.1161/strokeaha.112.662866] [Citation(s) in RCA: 108] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE We compared among young patients with ischemic stroke the distribution of vascular risk factors among sex, age groups, and 3 distinct geographic regions in Europe. METHODS We included patients with first-ever ischemic stroke aged 15 to 49 years from existing hospital- or population-based prospective or consecutive young stroke registries involving 15 cities in 12 countries. Geographic regions were defined as northern (Finland, Norway), central (Austria, Belgium, France, Germany, Hungary, The Netherlands, Switzerland), and southern (Greece, Italy, Turkey) Europe. Hierarchical regression models were used for comparisons. RESULTS In the study cohort (n=3944), the 3 most frequent risk factors were current smoking (48.7%), dyslipidemia (45.8%), and hypertension (35.9%). Compared with central (n=1868; median age, 43 years) and northern (n=1330; median age, 44 years) European patients, southern Europeans (n=746; median age, 41 years) were younger. No sex difference emerged between the regions, male:female ratio being 0.7 in those aged <34 years and reaching 1.7 in those aged 45 to 49 years. After accounting for confounders, no risk-factor differences emerged at the region level. Compared with females, males were older and they more frequently had dyslipidemia or coronary heart disease, or were smokers, irrespective of region. In both sexes, prevalence of family history of stroke, dyslipidemia, smoking, hypertension, diabetes mellitus, coronary heart disease, peripheral arterial disease, and atrial fibrillation positively correlated with age across all regions. CONCLUSIONS Primary preventive strategies for ischemic stroke in young adults-having high rate of modifiable risk factors-should be targeted according to sex and age at continental level.
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Affiliation(s)
- Jukka Putaala
- Department of Neurology, Helsinki University Central Hospital, Haartmaninkatu 4, FIN-00290, Helsinki, Finland.
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