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Wolff J, Matschinske J, Baumgart D, Pytlik A, Keck A, Natarajan A, von Schacky CE, Pauling JK, Baumbach J. Federated machine learning for a facilitated implementation of Artificial Intelligence in healthcare - a proof of concept study for the prediction of coronary artery calcification scores. J Integr Bioinform 2022; 19:jib-2022-0032. [PMID: 36054833 PMCID: PMC9800042 DOI: 10.1515/jib-2022-0032] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 08/03/2022] [Accepted: 08/11/2022] [Indexed: 01/09/2023] Open
Abstract
The implementation of Artificial Intelligence (AI) still faces significant hurdles and one key factor is the access to data. One approach that could support that is federated machine learning (FL) since it allows for privacy preserving data access. For this proof of concept, a prediction model for coronary artery calcification scores (CACS) has been applied. The FL was trained based on the data in the different institutions, while the centralized machine learning model was trained on one allocation of data. Both algorithms predict patients with risk scores ≥5 based on age, biological sex, waist circumference, dyslipidemia and HbA1c. The centralized model yields a sensitivity of c. 66% and a specificity of c. 70%. The FL slightly outperforms that with a sensitivity of 67% while slightly underperforming it with a specificity of 69%. It could be demonstrated that CACS prediction is feasible via both, a centralized and an FL approach, and that both show very comparable accuracy. In order to increase accuracy, additional and a higher volume of patient data is required and for that FL is utterly necessary. The developed "CACulator" serves as proof of concept, is available as research tool and shall support future research to facilitate AI implementation.
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Affiliation(s)
- Justus Wolff
- Chair of Experimental Bioinformatics, TUM School of Life Sciences Weihenstephan, Technical University of Munich, Maximus-von-Imhof-Forum 3, 85354Freising, Germany
- Syte – Strategy Institute for Digital Health, Hohe Bleichen 8, 20354Hamburg, Germany
| | - Julian Matschinske
- Chair of Computational Systems Biology, University of Hamburg, Notkestreet 9-11, 22607Hamburg, Germany
| | - Dietrich Baumgart
- Preventicum Essen, Theodor-Althoff-Str. 47 45133Essen, Germany
- Preventicum Duesseldorf, Koenigsallee 11, 40212Duesseldorf, Germany
| | - Anne Pytlik
- Preventicum Essen, Theodor-Althoff-Str. 47 45133Essen, Germany
- Preventicum Duesseldorf, Koenigsallee 11, 40212Duesseldorf, Germany
| | - Andreas Keck
- Syte – Strategy Institute for Digital Health, Hohe Bleichen 8, 20354Hamburg, Germany
| | - Arunakiry Natarajan
- Independent Researcher, Digital Health, Informatics and Data Science, Lower Saxony, Germany
| | - Claudio E. von Schacky
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, Technical University of Munich, Ismaningerstr. 22, 81675Munich, Germany
| | - Josch K. Pauling
- Chair of Experimental Bioinformatics, TUM School of Life Sciences Weihenstephan, Technical University of Munich, Maximus-von-Imhof-Forum 3, 85354Freising, Germany
- LipiTUM, Chair of Experimental Bioinformatics, TUM School of Life Sciences, Technical University of Munich, Maximus-von-Imhof-Forum 3, 85354Freising, Germany
| | - Jan Baumbach
- Chair of Computational Systems Biology, University of Hamburg, Notkestreet 9-11, 22607Hamburg, Germany
- Computational BioMedicine Lab, Institute of Mathematics and Computer Science, University of Southern Denmark, Campusvej 55, 5230Odense, Denmark
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Björnsson E, Thorleifsson G, Helgadóttir A, Guðnason T, Guðbjartsson T, Andersen K, Grétarsdóttir S, Ólafsson Í, Tragante V, Ólafsson ÓH, Jónsdóttir B, Eyjólfsson GI, Sigurðardóttir Ó, Thorgeirsson G, Guðbjartsson DF, Thorsteinsdóttir U, Hólm H, Stefánsson K. Association of Genetically Predicted Lipid Levels With the Extent of Coronary Atherosclerosis in Icelandic Adults. JAMA Cardiol 2021; 5:13-20. [PMID: 31746962 PMCID: PMC6902100 DOI: 10.1001/jamacardio.2019.2946] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Importance Genetic studies have evaluated the influence of blood lipid levels on the risk of coronary artery disease (CAD), but less is known about how they are associated with the extent of coronary atherosclerosis. Objective To estimate the contributions of genetically predicted blood lipid levels on the extent of coronary atherosclerosis. Design, Setting, and Participants This genetic study included Icelandic adults who had undergone coronary angiography or assessment of coronary artery calcium using cardiac computed tomography. The study incorporates data collected from January 1987 to December 2017 in Iceland in the Swedish Coronary Angiography and Angioplasty Registry and 2 registries of individuals who had undergone percutaneous coronary interventions and coronary artery bypass grafting. For each participant, genetic scores were calculated for levels of non-high-density lipoprotein cholesterol (non-HDL-C), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglycerides, based on reported effect sizes of 345 independent, lipid-associated variants. The genetic scores' predictive ability for lipid levels was assessed in more than 87 000 Icelandic adults. A mendelian randomization approach was used to estimate the contribution of each lipid trait. Exposures Genetic scores for levels of non-HDL-C, LDL-C, HDL-C, and triglycerides. Main Outcomes and Measures The extent of angiographic CAD and coronary artery calcium quantity. Results A total of 12 460 adults (mean [SD] age, 65.1 [10.7] years; 8383 men [67.3%]) underwent coronary angiography, and 4837 had coronary artery calcium assessed by computed tomography. A genetically predicted increase in non-HDL-C levels by 1 SD (38 mg/dL [to convert to millimoles per liter, multiply by 0.0259]) was associated with greater odds of obstructive CAD (odds ratio [OR], 1.83 [95% CI, 1.63-2.07]; P = 2.8 × 10-23). Among patients with obstructive CAD, there were significant associations with multivessel disease (OR, 1.26 [95% CI, 1.11-1.44]; P = 4.1 × 10-4) and 3-vessel disease (OR, 1.47 [95% CI, 1.26-1.72]; P = 9.2 × 10-7). There were also significant associations with the presence of coronary artery calcium (OR, 2.04 [95% CI, 1.70-2.44]; P = 5.3 × 10-15) and loge-transformed coronary artery calcium (effect, 0.70 [95% CI, 0.53-0.87]; P = 1.0 × 10-15). Genetically predicted levels of non-HDL-C remained associated with obstructive CAD and coronary artery calcium extent even after accounting for the association with LDL-C. Genetically predicted levels of HDL-C and triglycerides were associated individually with the extent of coronary atherosclerosis, but not after accounting for the association with non-HDL cholesterol. Conclusions and Relevance In this study, genetically predicted levels of non-HDL-C were associated with the extent of coronary atherosclerosis as estimated by 2 different methods. The association was stronger than for genetically predicted levels of LDL-C. These findings further support the notion that non-HDL-C may be a better marker of the overall burden of atherogenic lipoproteins than LDL-C.
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Affiliation(s)
- Eythór Björnsson
- deCODE genetics/Amgen Inc, Reykjavík, Iceland.,Faculty of Medicine, University of Iceland, Reykjavík, Iceland.,Division of Cardiology, Landspítali-The National University Hospital of Iceland, Reykjavík, Iceland
| | | | | | - Thórarinn Guðnason
- Division of Cardiology, Landspítali-The National University Hospital of Iceland, Reykjavík, Iceland
| | - Tómas Guðbjartsson
- Faculty of Medicine, University of Iceland, Reykjavík, Iceland.,Division of Cardiothoracic Surgery, Landspítali-The National University Hospital of Iceland, Reykjavík, Iceland
| | - Karl Andersen
- Faculty of Medicine, University of Iceland, Reykjavík, Iceland.,Division of Cardiology, Landspítali-The National University Hospital of Iceland, Reykjavík, Iceland
| | | | - Ísleifur Ólafsson
- Department of Clinical Biochemistry, Landspítali-The National University Hospital of Iceland, Reykjavík, Iceland
| | - Vinicius Tragante
- deCODE genetics/Amgen Inc, Reykjavík, Iceland.,Division of Heart & Lungs, Department of Cardiology, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Ólafur Hreiðar Ólafsson
- deCODE genetics/Amgen Inc, Reykjavík, Iceland.,Faculty of Medicine, University of Iceland, Reykjavík, Iceland
| | | | | | | | - Guðmundur Thorgeirsson
- deCODE genetics/Amgen Inc, Reykjavík, Iceland.,Faculty of Medicine, University of Iceland, Reykjavík, Iceland.,Division of Cardiology, Landspítali-The National University Hospital of Iceland, Reykjavík, Iceland
| | - Daníel F Guðbjartsson
- deCODE genetics/Amgen Inc, Reykjavík, Iceland.,School of Engineering and Natural Sciences, University of Iceland, Reykjavík, Iceland
| | - Unnur Thorsteinsdóttir
- deCODE genetics/Amgen Inc, Reykjavík, Iceland.,Faculty of Medicine, University of Iceland, Reykjavík, Iceland
| | - Hilma Hólm
- deCODE genetics/Amgen Inc, Reykjavík, Iceland
| | - Kári Stefánsson
- deCODE genetics/Amgen Inc, Reykjavík, Iceland.,Faculty of Medicine, University of Iceland, Reykjavík, Iceland
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Pechlivanis S, Lehmann N, Hoffmann P, Nöthen MM, Jöckel KH, Erbel R, Moebus S. Risk prediction for coronary heart disease by a genetic risk score - results from the Heinz Nixdorf Recall study. BMC MEDICAL GENETICS 2020; 21:178. [PMID: 32912153 PMCID: PMC7487988 DOI: 10.1186/s12881-020-01113-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 08/31/2020] [Indexed: 01/14/2023]
Abstract
BACKGROUND A Genetic risk score for coronary artery disease (CAD) improves the ability of predicting coronary heart disease (CHD). It is unclear whether i) the use of a CAD genetic risk score is superior to the measurement of coronary artery calcification (CAC) for CHD risk assessment and ii) the CHD risk assessment using a CAD genetic risk score differs between men and women. METHODS We included 4041 participants (age-range: 45-76 years, 1919 men) of the Heinz Nixdorf Recall study without CHD or stroke at baseline. A standardized weighted CAD genetic risk score was constructed using 70 known genetic variants. The risk score was divided into quintiles (Q1-Q5). We specified low (Q1), intermediate (Q2-Q4) and high (Q5) genetic risk groups. Incident CHD was defined as fatal and non-fatal myocardial infarction, stroke and coronary death. The association between the genetic risk score and genetic risk groups with incident CHD was assessed using Cox models to estimate hazard ratios (HR) and 95%-confidence intervals (CI). The models were adjusted by age and sex (Model1), as well as by established CHD risk factors (RF) and CAC (Model2). The analyses were further stratified by sex and controlled for multiple testing. RESULTS During a median follow-up time of 11.6 ± 3.7 years, 343 participants experienced CHD events (219 men). Per-standard deviation (SD) increase in the genetic risk score was associated with 18% increased risk for incident CHD (Model1: p = 0.002) which did not change after full adjustment (Model2: HR = 1.18 per-SD (p = 0.003)). In Model2 we observed a 60% increased CHD risk in the high (p = 0.009) compared to the low genetic risk group. Stratifying by sex, only men showed statistically significantly higher risk for CHD (Model2: HR = 1.23 per-SD (p = 0.004); intermediate: HR = 1.52 (p = 0.04) and high: HR = 1.88 (p = 0.008)) with no statistically significant risk observed in women. CONCLUSION Our results suggest that the CAD genetic risk score could be useful for CHD risk prediction, at least in men belonging to the higher genetic risk group, but it does not outbalance the value of CT-based quantification of CAC which works independently on both men and women and allows better risk stratification in both the genders.
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Affiliation(s)
- Sonali Pechlivanis
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, University Duisburg-Essen, Essen, Germany.
| | - Nils Lehmann
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, University Duisburg-Essen, Essen, Germany
| | - Per Hoffmann
- Department of Genomics, Life & Brain Center, University of Bonn, Bonn, Germany
- Division of Medical Genetics, Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Markus M Nöthen
- Department of Genomics, Life & Brain Center, University of Bonn, Bonn, Germany
| | - Karl-Heinz Jöckel
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, University Duisburg-Essen, Essen, Germany
| | - Raimund Erbel
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, University Duisburg-Essen, Essen, Germany
| | - Susanne Moebus
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, University Duisburg-Essen, Essen, Germany
- Centre for Urban Epidemiology, University Hospital Essen, Essen, Germany
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Klenke S, Lehmann N, Erbel R, Jöckel KH, Siffert W, Frey UH, Peters J. Genetic variations in G-protein signal pathways influence progression of coronary artery calcification: Results from the Heinz Nixdorf Recall study. Atherosclerosis 2020; 310:102-108. [PMID: 32680596 DOI: 10.1016/j.atherosclerosis.2020.06.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 06/18/2020] [Accepted: 06/24/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND AIMS Coronary artery calcification (CAC) is one of the most sensitive and specific markers of coronary atherosclerosis and believed to be heritable. We hypothesized that functionally relevant single-nucleotide polymorphisms (SNPs) in the G-protein signal pathway, which have been previously related to coronary artery disease, are associated with CAC progression. METHODS 3108 participants from the Heinz Nixdorf Recall study with CAC measurements at both baseline (CACb) and 5-year follow-up (CAC5y) were included. We genotyped SNPs rs1042714 (ADRB2), rs6026584 and rs12481583 (GNAS), and rs5443 (GNB3) and defined a priori risk alleles derived from literature data. Regression analyses were applied to measures of 5-year CAC progression, unadjusted, adjusted for age, sex, and adjusted for age, sex, log(CACb+1) as well as for cardiovascular risk factors. RESULTS The presence of one or more risk alleles was associated with a 26.9% (95% CI 5.5-52.4) increase in 5-year CAC progression (p = 0.011) and a 29.2% (95% CI 5.9-57.6) accelerated increase of CAC over the 5-year period compared to what was expected with respect to the baseline CAC percentile value (p = 0.012). Each of those risk alleles increased the 5-year CAC progression by 4.4% (95% CI 1.3-7.6, p = 0.006) and resulted in a 4.9% accelerated increase of CAC over the 5-year period (95% CI 1.6-8.4, p = 0.004). These unadjusted data did not change after adjustment. CONCLUSIONS Genetic variations in the G-protein signal pathway are associated with CAC progression in a cumulative fashion, indicating the importance of the pathway for genetic heritability in CAC progression and coronary artery disease.
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Affiliation(s)
- Stefanie Klenke
- Klinik für Anästhesiologie & Intensivmedizin, Universität Duisburg-Essen und Universitätsklinikum Essen, Essen, Germany.
| | - Nils Lehmann
- Institute for Medical Informatics, Biometry and Epidemiology, Universität Duisburg-Essen, Germany
| | - Raimund Erbel
- Institute for Medical Informatics, Biometry and Epidemiology, Universität Duisburg-Essen, Germany
| | - Karl-Heinz Jöckel
- Institute for Medical Informatics, Biometry and Epidemiology, Universität Duisburg-Essen, Germany
| | - Winfried Siffert
- Institut für Pharmakogenetik, Universität Duisburg-Essen and Universitätsklinikum Essen, Germany
| | - Ulrich H Frey
- Klinik für Anästhesiologie & Intensivmedizin, Universität Duisburg-Essen und Universitätsklinikum Essen, Essen, Germany; Klinik für Anästhesiologie, Operative Intensivmedizin, Schmerz- und Palliativmedizin, Marien Hospital Herne, Universitätsklinikum der Ruhr-Universität Bochum, Bochum, Germany
| | - Jürgen Peters
- Klinik für Anästhesiologie & Intensivmedizin, Universität Duisburg-Essen und Universitätsklinikum Essen, Essen, Germany
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Pechlivanis S, Moebus S, Lehmann N, Erbel R, Mahabadi AA, Hoffmann P, Jöckel KH, Nöthen MM, Bachmann HS. Genetic risk scores for coronary artery disease and its traditional risk factors: Their role in the progression of coronary artery calcification-Results of the Heinz Nixdorf Recall study. PLoS One 2020; 15:e0232735. [PMID: 32379805 PMCID: PMC7205301 DOI: 10.1371/journal.pone.0232735] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Accepted: 03/06/2020] [Indexed: 01/26/2023] Open
Abstract
Background Atherosclerosis is the primary cause of coronary artery disease (CAD). Several observational studies have examined the association of traditional CAD risk factors with the progression of coronary artery calcification (CAC). In our study we investigated the effect of 11 different genetic risk scores associated with CAD and CAD risk factors on the progression of CAC. Methods and results We included 3097 participants from the Heinz Nixdorf Recall study who had available CAC measurements at baseline (CACb) and at the 5-year follow-up (CAC5y). A weighted genetic risk score for CAD and each of the CAD-associated risk factors was constructed. Multiple regression analyses were applied to i) the difference between the observed log(CAC5y+1) (log(obs)) and expected log(CAC5y+1) (log(exp)) at the 5-year follow-up following the individual’s log(CACb+1) percentile for the time between scans (log(obs)–log(exp)) and ii) the 5-year CAC progression, defined as 5*(log(CAC5y+1)–log(CACb+1))/time between the scans, adjusted for age, sex, and log(CACb+1) as well as for risk factors. The median percent deviation from the expected (CAC5y+1) and the 5-year progression of (CAC+1) in our study were 0 (first quartile: Q1; third quartile: Q3: -0.32; 0.48) and 45.4% (0%; 171.0%) respectively. In the age-, sex- and log(CACb+1)-adjusted model, the per-standard deviation (SD) increase in CAD genetic risk score was associated with the percent deviation from the expected (CAC5y+1) (9.7% (95% confidence interval: 5.2%; 14.5%), p = 1.6x10-5) and the 5-year progression of CAC (7.1% (3.0%; 11.4%), p = 0.0005). The CAD genetic risk score explains an additional 0.6% of the observed phenotypic variance for “log(obs)–log(exp)” and 0.4% for 5-year progression of CAC. Additionally, the per-SD increase in the CAC genetic risk score was associated with the percent deviation from the expected (CAC5y+1) (6.2% (1.9%; 10.8%, p = 0.005)) explaining an additional 0.2% of the observed phenotypic variance. However, the per-SD increase in the CAC genetic risk score was not associated with the 5-year progression of CAC (4.4% (0.4%; 8.5%), p = 0.03) after multiple testing. Adjusting for risk factors did not change the results. None of the other genetic risk scores showed an association with the percent deviation from the expected (CAC5y+1) or with the 5-year progression of CAC. Conclusions The association of the CAC genetic risk score and the CAD genetic risk score provides evidence that genetic determinants for CAC and CAD influence the progression of CAC.
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Affiliation(s)
- Sonali Pechlivanis
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, University Duisburg-Essen, Essen, Germany
- * E-mail:
| | - Susanne Moebus
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, University Duisburg-Essen, Essen, Germany
- Centre for Urban Epidemiology, University Hospital Essen, Essen, Germany
| | - Nils Lehmann
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, University Duisburg-Essen, Essen, Germany
| | - Raimund Erbel
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, University Duisburg-Essen, Essen, Germany
| | - Amir A. Mahabadi
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center, University Hospital Essen, Essen, Germany
| | - Per Hoffmann
- Department of Genomics, Life & Brain Center, University of Bonn, Bonn, Germany
- Division of Medical Genetics, Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Karl-Heinz Jöckel
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, University Duisburg-Essen, Essen, Germany
| | - Markus M. Nöthen
- Department of Genomics, Life & Brain Center, University of Bonn, Bonn, Germany
| | - Hagen S. Bachmann
- Institute of Pharmacology and Toxicology, Centre for Biomedical Education and Research, Witten/Herdecke University, Witten, Germany
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Pathophysiological and Genetic Aspects of Vascular Calcification. Cardiol Res Pract 2020; 2020:5169069. [PMID: 32411445 PMCID: PMC7201852 DOI: 10.1155/2020/5169069] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 02/17/2020] [Accepted: 03/23/2020] [Indexed: 12/21/2022] Open
Abstract
Recent evidence suggests that vascular calcification is an independent cardiovascular risk factor (CRF) of morbidity and mortality. New studies point out the existence of a complex physiopathological mechanism that involves inflammation, oxidation, the release of chemical mediators, and genetic factors that promote the osteochondrogenic differentiation of vascular smooth muscle cells (VSMC). This review will evaluate the main mechanisms involved in the pathophysiology and genetics modulation of the process of vascular calcification. Objective. A systematic review of the pathophysiology factors involved in vascular calcification and its genetic influence was performed. Methods. A systematic review was conducted in the Medline and PubMed databases and were searched for studies concerning vascular calcification using the keywords and studies published until 2020/01 in English. Inclusion Criteria. Studies in vitro, animal models, and humans. These include cohort (both retrospective and prospective cohort studies), case-control, cross-sectional, and systematic reviews. Exclusion Criteria. Studies before 2003 of the existing literature.
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Xu X, Hua Y, Wang L, Hou W, Xia M. Correlation between risk factors of cerebrovascular disease and calcified plaque characteristics in patients with atherosclerotic severe carotid stenosis. Neurol Res 2020; 42:83-89. [PMID: 31900088 DOI: 10.1080/01616412.2019.1710403] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Objectives: The aim of this study was to evaluate the relationship between the risk factors of cerebral vascular diseases (CVD) and the characteristics of calcified plaques in patients with severe carotid arteriosclerosis stenosis (SCAS).Methods: A total of 402 patients with SCAS who were treated in our hospital between January to December 2016 were included in this study. The patients were divided into calcified plaque group and non-calcified plaque group according to the ultrasonography and computerized tomography angiography (CTA) or digital subtraction angiography (DSA) imaging of SCAS-responsible plaque and the characteristics of calcified plaques evaluated by high-frequency ultrasound.Results: The patients with long-term diabetes mellitus or higher levels of fasting blood glucose were more likely to develop calcified plaques (P = 0.00 and P = 0.021, respectively). In addition, the patients with calcified plaques were mostly smokers (P = 0.016). Their smoking duration and accumulative smoking exposure were higher than those without calcified plaque (P = 0.006 and P = 0.007, respectively). The basal location of calcification (P = 0.004) and the type of patchy calcification (P = 0.00) were both easier to appear in smokers, while non-smokers were more likely to have small granular calcification (P = 0.002). Furthermore, the carotid plaque calcification with mixed-location were more frequently seen in patients with hypertension (P = 0.016). The risk factors independently associated with plaque calcification were significantly associated with smoking status, smoking age, and accumulative smoking exposure, as well as age and diabetes mellitus (all P < 0.05).Conclusion: Smoking, diabetes mellitus and age were independent risk factors for carotid plaque calcification. Smoking and hypertension were associated with specific locations and types of plaque calcification.
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Affiliation(s)
- Xiangli Xu
- Department of vascular Ultrasonography, Xuanwu Hospital, Capital Medical University, Beijing, China.,Department of Ultrasound, The Second Hospital of Harbin, Harbin, Heilongjiang Province, China
| | - Yang Hua
- Department of vascular Ultrasonography, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Lili Wang
- Department of vascular Ultrasonography, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Weihong Hou
- Department of vascular Ultrasonography, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Mingyu Xia
- Department of vascular Ultrasonography, Xuanwu Hospital, Capital Medical University, Beijing, China
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Chen Y, Hu Z, Li M, Jia Y, He T, Liu Z, Wei D, Yu Y. Comparison of Nongated Chest CT and Dedicated Calcium Scoring CT for Coronary Calcium Quantification Using a 256-Dector Row CT Scanner. Acad Radiol 2019; 26:e267-e274. [PMID: 30685312 DOI: 10.1016/j.acra.2018.12.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 12/04/2018] [Accepted: 12/04/2018] [Indexed: 12/31/2022]
Abstract
BACKGROUND Coronary artery calcification (CAC) is a marker of atherosclerosis and an independent risk factor for cardiac-related mortality and frequently detected on noncontrast chest CT. We aimed to investigate the reliability and accuracy of determining CAC using noncontrast, nongated chest CT with 256-detector row. MATERIALS AND METHODS A total of 1318 patients for chest examination were enrolled to undergo both nongated chest CT and dedicated calcium-scoring CT (CSCT) on a 256-detector row CT scanner. The chest CT was scanned in fast-helical mode with 8 cm collimation, 0.28 second rotation speed and pitch 0.992:1 to cover entire chest. CSCT used single prospective ECG-triggered cardiac axial mode with 0.28 second rotation speed covering only the heart. CAC scores (Agatston, mass, and volume) were determined using both image sets and were statistically compared. RESULTS Sensitivity and specificity of nongated chest CT for determining positive CAC was 94.8% (182/192) and 100%, respectively. The agreement in assessing the quantitative Agatston, volume, and mass scores between the nongated chest CT and CSCT was almost perfect, with the intraclass correlation coefficient values of 0.998, 0.999, and 0.999, respectively. Additionally, there was a good agreement in CAC quantification between the nongated chest CT and dedicated CSCT with small coefficient of variation: mass score (9.0%), volume score (9.5%), and Agatston score (12.6%). CONCLUSION Nongated chest CT with 256-detector row is a reliable imaging mode for detecting and quantifying calcifications in coronary arteries compared with dedicated calcium-scoring CT.
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Ferraz-Amaro I, Winchester R, Gregersen PK, Reynolds RJ, Wasko MC, Oeser A, Chung CP, Stein CM, Giles JT, Bathon JM. Coronary Artery Calcification and Rheumatoid Arthritis: Lack of Relationship to Risk Alleles for Coronary Artery Disease in the General Population. Arthritis Rheumatol 2017; 69:529-541. [PMID: 27696788 DOI: 10.1002/art.39862] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Accepted: 09/06/2016] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Coronary artery disease (CAD) in the general population is characterized by an increased frequency of particular susceptibility single-nucleotide polymorphisms (SNPs). Because the frequency of CAD is increased among patients with rheumatoid arthritis (RA), we sought to determine whether the frequency of these SNPs is increased in RA patients with CAD, hypothesizing that RA could enhance CAD risk by acting through established genetic pathways predisposing to CAD. METHODS Coronary artery calcification (CAC) as detected by computed tomography was used as a measure of CAD in 561 patients with RA. One hundred SNPs associated with CAD in the general population were genotyped or imputed, and their relationship to CAC was established through multiple regression analysis for individual SNPs and a genetic risk score representing their cumulative effect. RESULTS Ninety-one CAD-related SNPs were genotyped successfully; of these, 81 exhibited no association with CAC (Agatston units) or different CAC categorizations, either individually or collectively, in the genetic risk score. Only rs579459 (ABO) and rs17676451 (HAL) had a consistent positive association between genotype and CAC, with a significant increase in the frequency of the effect allele in both homozygous and heterozygous genotype distributions. Five were variably negatively associated. Furthermore, a positive association between the Disease Activity Score in 28 joints and CAC was observed, and after adjustment for traditional cardiovascular risk factors, it was not modified by correcting for the CAD-related SNP genetic risk score. CONCLUSION The increased risk of CAC in patients with RA does not appear to operate primarily through established genetically regulated atherogenic mechanisms that are preponderant in the general population.
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Affiliation(s)
| | | | | | | | - Mary Chester Wasko
- West Penn Allegheny Health System, Pittsburgh, Pennsylvania, and Temple University School of Medicine, Philadelphia, Pennsylvania
| | - Anette Oeser
- Vanderbilt University Medical Center, Nashville, Tennessee
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10
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van der Laan SW, Fall T, Soumaré A, Teumer A, Sedaghat S, Baumert J, Zabaneh D, van Setten J, Isgum I, Galesloot TE, Arpegård J, Amouyel P, Trompet S, Waldenberger M, Dörr M, Magnusson PK, Giedraitis V, Larsson A, Morris AP, Felix JF, Morrison AC, Franceschini N, Bis JC, Kavousi M, O'Donnell C, Drenos F, Tragante V, Munroe PB, Malik R, Dichgans M, Worrall BB, Erdmann J, Nelson CP, Samani NJ, Schunkert H, Marchini J, Patel RS, Hingorani AD, Lind L, Pedersen NL, de Graaf J, Kiemeney LALM, Baumeister SE, Franco OH, Hofman A, Uitterlinden AG, Koenig W, Meisinger C, Peters A, Thorand B, Jukema JW, Eriksen BO, Toft I, Wilsgaard T, Onland-Moret NC, van der Schouw YT, Debette S, Kumari M, Svensson P, van der Harst P, Kivimaki M, Keating BJ, Sattar N, Dehghan A, Reiner AP, Ingelsson E, den Ruijter HM, de Bakker PIW, Pasterkamp G, Ärnlöv J, Holmes MV, Asselbergs FW. Cystatin C and Cardiovascular Disease: A Mendelian Randomization Study. J Am Coll Cardiol 2017; 68:934-45. [PMID: 27561768 PMCID: PMC5451109 DOI: 10.1016/j.jacc.2016.05.092] [Citation(s) in RCA: 75] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Revised: 05/12/2016] [Accepted: 05/18/2016] [Indexed: 01/09/2023]
Abstract
BACKGROUND Epidemiological studies show that high circulating cystatin C is associated with risk of cardiovascular disease (CVD), independent of creatinine-based renal function measurements. It is unclear whether this relationship is causal, arises from residual confounding, and/or is a consequence of reverse causation. OBJECTIVES The aim of this study was to use Mendelian randomization to investigate whether cystatin C is causally related to CVD in the general population. METHODS We incorporated participant data from 16 prospective cohorts (n = 76,481) with 37,126 measures of cystatin C and added genetic data from 43 studies (n = 252,216) with 63,292 CVD events. We used the common variant rs911119 in CST3 as an instrumental variable to investigate the causal role of cystatin C in CVD, including coronary heart disease, ischemic stroke, and heart failure. RESULTS Cystatin C concentrations were associated with CVD risk after adjusting for age, sex, and traditional risk factors (relative risk: 1.82 per doubling of cystatin C; 95% confidence interval [CI]: 1.56 to 2.13; p = 2.12 × 10−14). The minor allele of rs911119 was associated with decreased serum cystatin C (6.13% per allele; 95% CI: 5.75 to 6.50; p = 5.95 × 10−211), explaining 2.8% of the observed variation in cystatin C. Mendelian randomization analysis did not provide evidence for a causal role of cystatin C, with a causal relative risk for CVD of 1.00 per doubling cystatin C (95% CI: 0.82 to 1.22; p = 0.994), which was statistically different from the observational estimate (p = 1.6 × 10−5). A causal effect of cystatin C was not detected for any individual component of CVD. CONCLUSIONS Mendelian randomization analyses did not support a causal role of cystatin C in the etiology of CVD. As such, therapeutics targeted at lowering circulating cystatin C are unlikely to be effective in preventing CVD.
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Affiliation(s)
- Sander W van der Laan
- Laboratory of Experimental Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands.
| | - Tove Fall
- Department of Medical Sciences, Cardiovascular Epidemiology, Uppsala University, Uppsala, Sweden
| | - Aicha Soumaré
- INSERM U1219 Team Vintage, University of Bordeaux, Bordeaux, France
| | - Alexander Teumer
- Department SHIP-KEF, Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany; Deutsches Zentrum für Herz- und Kreislaufforschung (DZHK, German Centre for Cardiovascular Research) partner site, Greifswald, Germany
| | - Sanaz Sedaghat
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Jens Baumert
- Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Delilah Zabaneh
- Department of Genetics, Environment and Evolution, University College London, London, United Kingdom; Genetics Institute, University College London, London, United Kingdom
| | - Jessica van Setten
- Laboratory of Experimental Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Ivana Isgum
- Image Sciences Institute, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Tessel E Galesloot
- Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Johannes Arpegård
- Department of Emergency Medicine, Karolinska University Hospital-Solna, Stockholm, Sweden; Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Philippe Amouyel
- INSERM, University of Lille, Lille, France; Institut Pasteur de Lille, Lille, France
| | - Stella Trompet
- Department of Cardiology C5-P, Leiden University Medical Center, Leiden, the Netherlands; Department of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, the Netherlands
| | - Melanie Waldenberger
- Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany; Research Unit of Molecular Epidemiology Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Marcus Dörr
- Deutsches Zentrum für Herz- und Kreislaufforschung (DZHK, German Centre for Cardiovascular Research) partner site, Greifswald, Germany; Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany
| | - Patrik K Magnusson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | | | - Anders Larsson
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Andrew P Morris
- Department of Biostatistics, University of Liverpool, Liverpool, United Kingdom; Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, United Kingdom
| | - Janine F Felix
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Alanna C Morrison
- Department of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas Health Science Center, Houston, Texas
| | - Nora Franceschini
- Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina
| | - Joshua C Bis
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, Washington
| | - Maryam Kavousi
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Christopher O'Donnell
- Department of Cardiology, Boston Veterans Administration Healthcare, West Roxbury, Massachusetts; National Heart, Lung, and Blood Institute Framingham Heart Study, Framingham, Massachusetts
| | - Fotios Drenos
- Centre for Cardiovascular Genetics, Institute of Cardiovascular Sciences; University College London, London, United Kingdom; MRC Integrative Epidemiology Unit, School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
| | - Vinicius Tragante
- Department of Cardiology, Division Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Patricia B Munroe
- National Institute for Health Research Cardiovascular Biomedical Research Unit, William Harvey Research Institute, Queen Mary University of London, London, United Kingdom
| | - Rainer Malik
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Martin Dichgans
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-University Munich, Munich, Germany; Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Bradford B Worrall
- Departments of Neurology and Health Evaluation Sciences, University of Virginia, Charlottesville, Virginia
| | - Jeanette Erdmann
- Institute for Integrative and Experimental Genomics, University of Lübeck, Lübeck, Germany
| | - Christopher P Nelson
- Department of Cardiovascular Sciences, University of Leicester, British Heart Foundation Cardiovascular Research Centre, Glenfield Hospital, Leicester, United Kingdom; National Institute for Health Research Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, Leicester, United Kingdom
| | - Nilesh J Samani
- Department of Cardiovascular Sciences, University of Leicester, British Heart Foundation Cardiovascular Research Centre, Glenfield Hospital, Leicester, United Kingdom; National Institute for Health Research Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, Leicester, United Kingdom
| | - Heribert Schunkert
- Deutsches Herzzentrum München, Technische Universität München, Munich, Germany; DZHK, German Centre for Cardiovascular Research, partner site Munich Heart Alliance, Munich, Germany
| | - Jonathan Marchini
- Department of Statistics, University of Oxford, Oxford, United Kingdom
| | - Riyaz S Patel
- The Genetic Epidemiology Research Group, Institute of Cardiovascular Science, University College London, London, United Kingdom; Bart's Heart Centre, London, United Kingdom; Farr Institute of Health Informatics, University College London, London, United Kingdom
| | - Aroon D Hingorani
- The Genetic Epidemiology Research Group, Institute of Cardiovascular Science, University College London, London, United Kingdom
| | - Lars Lind
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Nancy L Pedersen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Jacqueline de Graaf
- Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Internal Medicine, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Lambertus A L M Kiemeney
- Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Sebastian E Baumeister
- Department SHIP-KEF, Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany; Institute for Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - Oscar H Franco
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Albert Hofman
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - André G Uitterlinden
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Wolfgang Koenig
- Deutsches Zentrum für Herz- und Kreislaufforschung (DZHK, German Centre for Cardiovascular Research) partner site, Greifswald, Germany; Deutsches Herzzentrum München, Technische Universität München, Munich, Germany; Department of Internal Medicine II-Cardiology, University of Ulm Medical Center, Ulm, Germany
| | - Christa Meisinger
- Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Annette Peters
- Deutsches Zentrum für Herz- und Kreislaufforschung (DZHK, German Centre for Cardiovascular Research) partner site, Greifswald, Germany; Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Barbara Thorand
- Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - J Wouter Jukema
- Department of Cardiology C5-P, Leiden University Medical Center, Leiden, the Netherlands; Durrer Center for Cardiogenetic Research, ICIN-Netherlands Heart Institute, Utrecht, the Netherlands
| | - Bjørn Odvar Eriksen
- Metabolic and Renal Research Group, UiT The Arctic University of Norway, Tromsø, Norway; Section of Nephrology, University Hospital of North Norway, Tromsø, Norway
| | - Ingrid Toft
- Section of Nephrology, University Hospital of North Norway, Tromsø, Norway
| | - Tom Wilsgaard
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - N Charlotte Onland-Moret
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Yvonne T van der Schouw
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | | | - Meena Kumari
- Biological and Social Epidemiology, Institute for Social and Economic Research, University of Essex, Essex, United Kingdom
| | - Per Svensson
- Department of Emergency Medicine, Karolinska University Hospital-Solna, Stockholm, Sweden; Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Pim van der Harst
- Durrer Center for Cardiogenetic Research, ICIN-Netherlands Heart Institute, Utrecht, the Netherlands; Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands; Department of Genetics, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Mika Kivimaki
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Brendan J Keating
- Department of Surgery, Division of Transplantation, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | | | - Abbas Dehghan
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Alex P Reiner
- Department of Epidemiology, University of Washington, Seattle, Washington
| | - Erik Ingelsson
- Department of Medical Sciences, Molecular Epidemiology and Science for Life Laboratory, Uppsala University, Uppsala, Sweden; Department of Medicine, Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, California
| | - Hester M den Ruijter
- Laboratory of Experimental Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Paul I W de Bakker
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands; Department of Medical Genetics, Center for Molecular Medicine, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Gerard Pasterkamp
- Laboratory of Experimental Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands; Laboratory of Clinical Chemistry and Hematology, Division of Laboratories and Pharmacy, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Johan Ärnlöv
- Department of Medical Sciences, Cardiovascular Epidemiology, Uppsala University, Uppsala, Sweden
| | - Michael V Holmes
- Clinical Trial Service Unit & Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom.
| | - Folkert W Asselbergs
- Department of Cardiology, Division Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands; Durrer Center for Cardiogenetic Research, ICIN-Netherlands Heart Institute, Utrecht, the Netherlands; Institute of Cardiovascular Science, Faculty of Population Health Sciences, University College London, London, United Kingdom.
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11
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van Iperen EPA, Sivapalaratnam S, Holmes MV, Hovingh GK, Zwinderman AH, Asselbergs FW. Genetic analysis of emerging risk factors in coronary artery disease. Atherosclerosis 2016; 254:35-41. [PMID: 27684604 DOI: 10.1016/j.atherosclerosis.2016.09.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Revised: 08/15/2016] [Accepted: 09/07/2016] [Indexed: 12/22/2022]
Abstract
BACKGROUND AND AIMS Type 2 diabetes (T2D), low-density lipoprotein-cholesterol (LDL-c), body mass index (BMI), blood pressure and smoking are established risk factors that play a causal role in coronary artery disease (CAD). Numerous common genetic variants associating with these and other risk factors have been identified, but their association with CAD has not been comprehensively examined in a single study. Our goal was to comprehensively evaluate the associations of established and emerging risk factors with CAD using genetic variants identified from Genome-wide Association Studies (GWAS). METHODS We tested the effect of 60 traditional and putative risk factors with CAD, using summary statistics obtained in GWAS. We approximated the regression of a response variable onto an additive multi-SNP genetic risk score in the Coronary Artery DIsease Genomewide Replication And Meta-analysis (CARDIoGRAM) consortium dataset weighted by the effect of the SNP on the risk factors. RESULTS The strongest association with risk of CAD was for LDL-c SNPs (p = 3.96E-34). For non-established CAD risk factors, we found significant CAD associations for coronary artery calcification (CAC), Lp(a), LP-PLA2 activity, plaque, vWF and FVIII. In an attempt to identify independent associations between risk factors and CAD, only SNPs with an effect on the target trait were included. This identified CAD associations for Lp(a)(p = 1.77E-21), LDL-c (p = 4.16E-06), triglycerides (TG) (p = 1.94E-05), height (p = 2.06E-05), CAC (p = 3.13E-23) and carotid plaque (p = 2.08E-05). CONCLUSIONS We identified SNPs associated with the emerging risk factors Lp(a), TG, plaque, height and CAC to be independently associated with risk of CAD. This provides further support for-ongoing clinical trials of Lp(a) and TG, and suggests that CAC and plaque could be used as surrogate markers for CAD in clinical trials.
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Affiliation(s)
- Erik P A van Iperen
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Center, Amsterdam, The Netherlands; Durrer Center for Cardiovascular Research, Netherlands Heart Institute, Utrecht, The Netherlands.
| | | | - Michael V Holmes
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Old Road Campus, Roosevelt Drive, Oxford OX3 7LF, United Kingdom
| | - G Kees Hovingh
- Department of Vascular Medicine Academic Medical Center, Amsterdam, The Netherlands
| | - Aeilko H Zwinderman
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Center, Amsterdam, The Netherlands
| | - Folkert W Asselbergs
- Durrer Center for Cardiovascular Research, Netherlands Heart Institute, Utrecht, The Netherlands; Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, The Netherlands; Institute of Cardiovascular Science, Faculty of Population Health Sciences, University College London, London, United Kingdom.
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12
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Siemelink M, van der Laan S, van Setten J, de Vries J, de Borst G, Moll F, den Ruijter H, Asselbergs F, Pasterkamp G, de Bakker P. Common variants associated with blood lipid levels do not affect carotid plaque composition. Atherosclerosis 2015; 242:351-6. [DOI: 10.1016/j.atherosclerosis.2015.07.041] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Revised: 07/04/2015] [Accepted: 07/24/2015] [Indexed: 10/23/2022]
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13
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Smith JA, Ware EB, Middha P, Beacher L, Kardia SLR. Current Applications of Genetic Risk Scores to Cardiovascular Outcomes and Subclinical Phenotypes. CURR EPIDEMIOL REP 2015; 2:180-190. [PMID: 26269782 PMCID: PMC4527979 DOI: 10.1007/s40471-015-0046-4] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Genetic risk scores are a useful tool for examining the cumulative predictive ability of genetic variation on cardiovascular disease. Important considerations for creating genetic risk scores include the choice of genetic variants, weighting, and comparability across ethnicities. Genetic risk scores that use information from genome-wide meta-analyses can successfully predict cardiovascular outcomes and subclinical phenotypes, yet there is limited clinical utility of these scores beyond traditional cardiovascular risk factors in many populations. Novel uses of genetic risk scores include evaluating the genetic contribution of specific intermediate traits or risk factors to cardiovascular disease, risk prediction in high-risk populations, gene-by-environment interaction studies, and Mendelian randomization studies. Though questions remain about the ultimate clinical utility of the genetic risk score, further investigation in high-risk populations and new ways to combine genetic risk scores with traditional risk factors may prove to be fruitful.
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Affiliation(s)
- Jennifer A. Smith
- />Department of Epidemiology, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109 USA
| | - Erin B. Ware
- />Department of Epidemiology, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109 USA
- />Research Center for Group Dynamics, Institute for Social Research, University of Michigan, Ann Arbor, MI 48104 USA
| | - Pooja Middha
- />Department of Epidemiology, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109 USA
| | - Lisa Beacher
- />Department of Epidemiology, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109 USA
| | - Sharon L. R. Kardia
- />Department of Epidemiology, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109 USA
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