Cited by 66Genetic Associations and EpidemiologyAtherosclerosis and Cardiovascular DiseasesLipoproteins and Cardiovascular Health

Multiethnic Exome-Wide Association Study of Subclinical Atherosclerosis

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Natarajan, Pradeep, Bis, Joshua C., Bielak, Lawrence F., Cox, Amanda J., Dörr, Marcus, Feitosa, Mary F., Franceschini, Nora, Guo, Xiuqing +92 more·2016·Circulation: Cardiovascular Genetics

Abstract

Background—: The burden of subclinical atherosclerosis in asymptomatic individuals is heritable and associated with elevated risk of developing clinical coronary heart disease. We sought to identify genetic variants in protein-coding regions associated with subclinical atherosclerosis and the risk of subsequent coronary heart disease. Methods and Results—: We studied a total of 25 109 European ancestry and African ancestry participants with coronary artery calcification (CAC) measured by cardiac computed tomography and 52 869 participants with common carotid intima–media thickness measured by ultrasonography within the CHARGE Consortium (Cohorts for Heart and Aging Research in Genomic Epidemiology). Participants were genotyped for 247 870 DNA sequence variants (231 539 in exons) across the genome. A meta-analysis of exome-wide association studies was performed across cohorts for CAC and carotid intima–media thickness. APOB p.Arg3527Gln was associated with 4-fold excess CAC ( P =3×10 − 10 ). The APOE ε2 allele (p.Arg176Cys) was associated with both 22.3% reduced CAC ( P =1×10 − 12 ) and 1.4% reduced carotid intima–media thickness ( P =4×10 − 14 ) in carriers compared with noncarriers. In secondary analyses conditioning on low-density lipoprotein cholesterol concentration, the ε2 protective association with CAC, although attenuated, remained strongly significant. Additionally, the presence of ε2 was associated with reduced risk for coronary heart disease (odds ratio 0.77; P =1×10 − 11 ). Conclusions—: Exome-wide association meta-analysis demonstrates that protein-coding variants in APOB and APOE associate with subclinical atherosclerosis. APOE ε2 represents the first significant association for multiple subclinical atherosclerosis traits across multiple ethnicities, as well as clinical coronary heart disease.

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  • APOEε2 has been associated with reduced risk of coronary and carotid artery diseases in diverse populations.

    “By contrast, APOEε2 has been associated with reduced risk of coronary and carotid artery diseases in diverse populations86.”

    From Multifaceted roles of APOE in Alzheimer disease (2024) · cites this paper as [86]

    The Results (Carotid Intima Media Thickness Association; page unavailable) report reduced carotid intima-media thickness with APOE ε2 in European- and African-ancestry cohorts. The Methods and Results passage also reports reduced coronary heart disease risk. Carotid intima-media thickness is a measure of subclinical atherosclerosis, however, not a measured reduction in the risk of clinical carotid artery disease. (LLM, conf=0.88)

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Authors
Natarajan, P., Bis, J. C., Bielak, L. F., Cox, A. J., Dörr, M., Feitosa, M. F., Franceschini, N., Guo, X., Hwang, S.-J., Isaacs, A., Jhun, M. A., Kavousi, M., Li-Gao, R., Lyytikäinen, L.-P., Marioni, R. E., Schminke, U., Stitziel, N. O., Tada, H., van Setten, J., Smith, A. V., Vojinovic, D., Yanek, L. R., Yao, J., Yerges-Armstrong, L. M., Amin, N., Baber, U., Borecki, I. B., Carr, J. J., Chen, Y.-D. I., Cupples, L. A., de Jong, P. A., de Koning, H., de Vos, B. D., Demirkan, A., Fuster, V., Franco, O. H., Goodarzi, M. O., Harris, T. B., Heckbert, S. R., Heiss, G., Hoffmann, U., Hofman, A., Išgum, I., Jukema, J. W., Kähönen, M., Kardia, S. L. R., Kral, B. G., Launer, L. J., Massaro, J., Mehran, R., Mitchell, B. D., Mosley, T. H., de Mutsert, R., Newman, A. B., Nguyen, K.-D., North, K. E., O’Connell, J. R., Oudkerk, M., Pankow, J. S., Peloso, G. M., Post, W., Province, M. A., Raffield, L. M., Raitakari, O. T., Reilly, D. F., Rivadeneira, F., Rosendaal, F., Sartori, S., Taylor, K. D., Teumer, A., Trompet, S., Turner, S. T., Uitterlinden, A. G., Vaidya, D., van der Lugt, A., Völker, U., Wardlaw, J. M., Wassel, C. L., Weiss, S., Wojczynski, M. K., Becker, D. M., Becker, L. C., Boerwinkle, E., Bowden, D. W., Deary, I. J., Dehghan, A., Felix, S. B., Gudnason, V., Lehtimäki, T., Mathias, R., Mook-Kanamori, D. O., Psaty, B. M., Rader, D. J., Rotter, J. I., Wilson, J. G., van Duijn, C. M., Völzke, H., Kathiresan, S., Peyser, P. A., & O’Donnell, C. J.
Affiliations
Harvard University (US)
Venue
Circulation: Cardiovascular Genetics
Published
2016-12
Volume
9
Issue
6
Pages
511-520
ISSN
  • 1942-325X (ISSN-L)
  • 1942-3268
OpenAlex
W2550865537
Cited by
66
References
5
Citations by year
2026: 3 · 2025: 7 · 2024: 5 · 2023: 6 · 2022: 9 · 2021: 6 · 2020: 7 · 2019: 9 · 2018: 8 · 2017: 6
FWCI
6.19
Type
journal article
Language
en
Open access
Locations
  • Circulation Cardiovascular Genetics (publishedVersion)
  • PubMed (publishedVersion)
  • Research Publications (Maastricht University) (publishedVersion, other-oa)
  • Edinburgh Research Explorer (University of Edinburgh) (publishedVersion, other-oa)
  • University of Groningen research database (University of Groningen / Centre for Information Technology) (publishedVersion)
  • PubMed Central (acceptedVersion)
  • Pure Amsterdam UMC (submittedVersion, cc-by)
  • Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
  • EUR Research Repository (Erasmus University Rotterdam) (submittedVersion)
  • Data Archiving and Networked Services (DANS) (submittedVersion)
  • Leiden Repository (Leiden University) (submittedVersion)
  • Utrecht University Repository (Utrecht University) (submittedVersion, other-oa)
  • UCL Discovery (University College London) (submittedVersion)
  • eScholarship (California Digital Library) (submittedVersion)
  • Griffith Research Online (submittedVersion)
  • University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
  • Research Publications (Maastricht University) (submittedVersion, other-oa)
  • Utrecht University Repository (Utrecht University) (submittedVersion)
Funders
  • U.S. Department of Veterans Affairs
  • Massachusetts General Hospital
  • Vanderbilt University
  • University of Pennsylvania
  • University of Minnesota
  • University of Washington
  • Johns Hopkins University
  • University of Pittsburgh
  • Harvard T.H. Chan School of Public Health
  • Regeneron Pharmaceuticals
  • Deutsches Zentrum für Herz-Kreislaufforschung
  • University of Vermont
  • School of Public Health, University of Michigan
  • University of Texas Health Science Center at Houston
  • Cedars-Sinai Medical Center
  • Broad Institute
  • Kanazawa University
  • Imperial College London
  • Universiteit Leiden
  • Rijksuniversiteit Groningen
  • Universiteit Maastricht
  • Erasmus Medisch Centrum
  • Tampereen Yliopisto
  • Leids Universitair Medisch Centrum
  • Universitair Medisch Centrum Groningen
  • Háskóli Íslands
  • Turun Yliopisto
  • Tays
  • Turun Yliopistollinen Keskussairaala
  • Hjartavernd
  • National Institutes of Health (1r01hl120393-01a1, UL1TR000124, n01hc25195-41-0-1, UL1TR001881)
  • University of North Carolina at Chapel Hill
  • Perelman School of Medicine, University of Pennsylvania
  • Graduate School of Public Health, University of Pittsburgh
  • Medical Research Council (MR/K026992/1)
  • Queensland Brain Institute
  • Netherlands Heart Institute
  • National Heart, Lung, and Blood Institute (R01-HL120393, R01HL112064, U01HL130114, ZIAHL006002, R01HL119443, N01-HC-025195, R01HL105756, R01HL117078, T32HL007055)
  • National Institute of Diabetes and Digestive and Kidney Diseases (P30DK063491)
  • NIH Clinical Center
  • National Center for Advancing Translational Sciences
  • Institute of Genetics
Topics
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genetic Associations and Epidemiology
  • Life Sciences › Immunology and Microbiology › Immunology › Atherosclerosis and Cardiovascular Diseases
  • Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
Keywords
subclinical atherosclerosis, coronary artery calcification, carotid intima-media thickness, apolipoprotein B, APOE ε2 allele, coronary heart disease risk, genetic variants, LDL cholesterol, CHARGE consortium
MeSH terms
Computed Tomography Angiography, Carotid Artery Diseases, Coronary Artery Disease, Gene Frequency, Genetic Markers, Humans, Cholesterol, LDL, Phenotype, Prognosis, Risk Factors, Odds Ratio, Coronary Angiography, Risk Assessment, Genetic Predisposition to Disease, Oligonucleotide Array Sequence Analysis, Black People, White People, Apolipoprotein B-100, Apolipoprotein E2, Genome-Wide Association Study, Asymptomatic Diseases, Carotid Intima-Media Thickness, Exome, Vascular Calcification

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