Abstract

Carotid artery intima media thickness (cIMT) and carotid plaque are measures of subclinical atherosclerosis associated with ischemic stroke and coronary heart disease (CHD). Here, we undertake meta-analyses of genome-wide association studies (GWAS) in 71,128 individuals for cIMT, and 48,434 individuals for carotid plaque traits. We identify eight novel susceptibility loci for cIMT, one independent association at the previously-identified PINX1 locus, and one novel locus for carotid plaque. Colocalization analysis with nearby vascular expression quantitative loci (cis-eQTLs) derived from arterial wall and metabolic tissues obtained from patients with CHD identifies candidate genes at two potentially additional loci, ADAMTS9 and LOXL4. LD score regression reveals significant genetic correlations between cIMT and plaque traits, and both cIMT and plaque with CHD, any stroke subtype and ischemic stroke. Our study provides insights into genes and tissue-specific regulatory mechanisms linking atherosclerosis both to its functional genomic origins and its clinical consequences in humans.

Details

Title
GWAS and colocalization analyses implicate carotid intima-media thickness and carotid plaque loci in cardiovascular outcomes
Author
Franceschini, Nora 1 ; Giambartolomei, Claudia 2   VIAFID ORCID Logo  ; de Vries, Paul S 3 ; Finan, Chris 4 ; Bis, Joshua C 5 ; Huntley, Rachael P 4   VIAFID ORCID Logo  ; Lovering, Ruth C 4   VIAFID ORCID Logo  ; Tajuddin, Salman M 6   VIAFID ORCID Logo  ; Winkler, Thomas W 7   VIAFID ORCID Logo  ; Graff, Misa 1 ; Kavousi, Maryam 8 ; Dale, Caroline 9 ; Smith, Albert V 10 ; Hofer, Edith 11 ; van Leeuwen, Elisabeth M 8 ; Nolte, Ilja M 12   VIAFID ORCID Logo  ; Lu, Lingyi 13 ; Scholz, Markus 14   VIAFID ORCID Logo  ; Muralidharan Sargurupremraj 15 ; Pitkänen, Niina 16 ; Franzén, Oscar 17 ; Joshi, Peter K 18   VIAFID ORCID Logo  ; Noordam, Raymond 19 ; Marioni, Riccardo E 20 ; Shih-Jen Hwang 21 ; Musani, Solomon K 22 ; Schminke, Ulf 23 ; Palmas, Walter 24 ; Isaacs, Aaron 25   VIAFID ORCID Logo  ; Correa, Adolfo 22   VIAFID ORCID Logo  ; Zonderman, Alan B 6 ; Hofman, Albert 26 ; Teumer, Alexander 27   VIAFID ORCID Logo  ; Cox, Amanda J 28 ; Uitterlinden, André G 29 ; Wong, Andrew 30   VIAFID ORCID Logo  ; Smit, Andries J 31 ; Newman, Anne B 32   VIAFID ORCID Logo  ; Britton, Annie 33 ; Ruusalepp, Arno 34 ; Sennblad, Bengt 35   VIAFID ORCID Logo  ; Hedblad, Bo 36 ; Pasaniuc, Bogdan 37 ; Penninx, Brenda W 38 ; Langefeld, Carl D 13 ; Wassel, Christina L 39 ; Tzourio, Christophe 15 ; Fava, Cristiano 40 ; Baldassarre, Damiano 41   VIAFID ORCID Logo  ; Daniel H O’Leary 42 ; Teupser, Daniel 43 ; Kuh, Diana 30   VIAFID ORCID Logo  ; Tremoli, Elena 44 ; Mannarino, Elmo 45 ; Grossi, Enzo 46 ; Boerwinkle, Eric 47 ; Schadt, Eric E 17   VIAFID ORCID Logo  ; Ingelsson, Erik 48 ; Veglia, Fabrizio 49 ; Rivadeneira, Fernando 29   VIAFID ORCID Logo  ; Beutner, Frank 50 ; Chauhan, Ganesh 51 ; Heiss, Gerardo 1 ; Snieder, Harold 12 ; Campbell, Harry 18 ; Völzke, Henry 27 ; Markus, Hugh S 52 ; Deary, Ian J 53 ; Jukema, J Wouter 54   VIAFID ORCID Logo  ; de Graaf, Jacqueline 55 ; Price, Jacqueline 18 ; Pott, Janne 14 ; Hopewell, Jemma C 56 ; Liang, Jingjing 57 ; Thiery, Joachim 58 ; Engmann, Jorgen 4 ; Gertow, Karl 59 ; Rice, Kenneth 60   VIAFID ORCID Logo  ; Taylor, Kent D 61 ; Klodian Dhana 62   VIAFID ORCID Logo  ; Lambertus A L M Kiemeney 63 ; Lind, Lars 64 ; Raffield, Laura M 65 ; Launer, Lenore J 6 ; Holdt, Lesca M 43 ; Dörr, Marcus 66 ; Dichgans, Martin 67   VIAFID ORCID Logo  ; Traylor, Matthew 52   VIAFID ORCID Logo  ; Sitzer, Matthias 68 ; Kumari, Meena 69 ; Kivimaki, Mika 33   VIAFID ORCID Logo  ; Nalls, Mike A 70 ; Melander, Olle 36 ; Raitakari, Olli 71 ; Franco, Oscar H 72 ; Rueda-Ochoa, Oscar L 73 ; Roussos, Panos 74   VIAFID ORCID Logo  ; Whincup, Peter H 75 ; Amouyel, Philippe 76   VIAFID ORCID Logo  ; Giral, Philippe 77 ; Anugu, Pramod 22 ; Wong, Quenna 78 ; Malik, Rainer 79 ; Rauramaa, Rainer 80 ; Burkhardt, Ralph 81   VIAFID ORCID Logo  ; Hardy, Rebecca 30 ; Schmidt, Reinhold 82 ; de Mutsert, Renée 83 ; Morris, Richard W 84   VIAFID ORCID Logo  ; Strawbridge, Rona J 85 ; S Goya Wannamethee 86 ; Hägg, Sara 87   VIAFID ORCID Logo  ; Shah, Sonia 4 ; McLachlan, Stela 18 ; Trompet, Stella 88 ; Seshadri, Sudha 89 ; Kurl, Sudhir 90 ; Heckbert, Susan R 91 ; Ring, Susan 92 ; Harris, Tamara B 6 ; Lehtimäki, Terho 93 ; Galesloot, Tessel E 63 ; Shah, Tina 4 ; de Faire, Ulf 94 ; Plagnol, Vincent 95 ; Rosamond, Wayne D 1 ; Post, Wendy 96 ; Zhu, Xiaofeng 57 ; Zhang, Xiaoling 97 ; Guo, Xiuqing 98 ; Saba, Yasaman 99 ; Okada, Yukinori 100 ; Mishra, Aniket 101 ; Rutten-Jacobs, Loes 102 ; Giese, Anne-Katrin 103 ; Sander W van der Laan 104 ; Gretarsdottir, Solveig 105 ; Anderson, Christopher D 106 ; Chong, Michael 107 ; Adams, Hieab H H 8 ; Ago, Tetsuro 108 ; Almgren, Peter 109 ; Ay, Hakan 110 ; Bartz, Traci M 111 ; Benavente, Oscar R 112 ; Bevan, Steve 113 ; Boncoraglio, Giorgio B 114 ; Brown, Robert D, Jr 115 ; Butterworth, Adam S 116 ; Carrera, Caty 117 ; Carty, Cara L 118 ; Chasman, Daniel I 119 ; Wei-Min, Chen 120 ; Cole, John W 121 ; Cotlarciuc, Ioana 122 ; Cruchaga, Carlos 123 ; Danesh, John 124 ; Paul I W de Bakker 125 ; DeStefano, Anita L 126 ; den Hoed, Marcel 127 ; Duan, Qing 128 ; Engelter, Stefan T 129 ; Falcone, Guido J 130 ; Gottesman, Rebecca F 131 ; Grewal, Raji P 132 ; Gustafsson, Stefan 133 ; Haessler, Jeffrey 134 ; Ahamad Hassan 135 ; Havulinna, Aki S 136 ; Holliday, Elizabeth G 137 ; Howard, George 138 ; Fang-Chi, Hsu 13 ; Hyacinth, Hyacinth I 139 ; Ikram, M Arfan 8 ; Irvin, Marguerite R 140 ; Xueqiu Jian 141 ; Jiménez-Conde, Jordi 142 ; Johnson, Julie A 143 ; Kanai, Masahiro 2 ; Keene, Keith L 144 ; Kissela, Brett M 145 ; Kleindorfer, Dawn O 145 ; Kooperberg, Charles 134 ; Kubo, Michiaki 146 ; Lange, Leslie 147 ; Langenberg, Claudia 128 ; Jin-Moo, Lee 148 ; Lemmens, Robin 149 ; Leys, Didier 150 ; Lewis, Cathryn M 151 ; Wei-Yu, Lin 152 ; Lindgren, Arne G 153 ; Lorentzen, Erik 154 ; Magnusson, Patrik K 87 ; Maguire, Jane 155 ; Manichaikul, Ani 120 ; McArdle, Patrick F 156 ; Meschia, James F 157 ; Mosley, Thomas H 158 ; Ninomiya, Toshiharu 159 ; Martin J O’Donnell 160 ; Pulit, Sara L 161 ; Rannikmäe, Kristiina 162 ; Reiner, Alexander P 163 ; Rexrode, Kathryn M 164 ; Rich, Stephen S 120 ; Ridker, Paul M 119 ; Rost, Natalia S 103 ; Rothwell, Peter M 165 ; Rundek, Tatjana 166 ; Sacco, Ralph L 166 ; Sakaue, Saori 167 ; Sale, Michele M 120 ; Salomaa, Veikko 168 ; Sapkota, Bishwa R 169 ; Schmidt, Carsten O 170 ; Sharma, Pankaj 122 ; Slowik, Agnieszka 171 ; Sudlow, Cathie L M 172 ; Tanislav, Christian 173 ; Tatlisumak, Turgut 174 ; Thijs, Vincent N S 175 ; Thorleifsson, Gudmar 105 ; Thorsteinsdottir, Unnur 105 ; Tiedt, Steffen 79 ; Walters, Matthew 176 ; Wareham, Nicholas J 128 ; Wassertheil-Smoller, Sylvia 177 ; Wiggins, Kerri L 5 ; Yang, Qiong 178 ; Salim Yusuf 107 ; Pastinen, Tomi 179 ; Koplev, Simon 180 ; Codoni, Veronica 181 ; Civelek, Mete 182 ; Smith, Nick 183 ; Trégouët, David A 181 ; Christophersen, Ingrid E 184 ; Roselli, Carolina 185 ; Lubitz, Steven A 186 ; Ellinor, Patrick T 186 ; Tai, E Shyong 187 ; Kooner, Jaspal S 188 ; Kato, Norihiro 189 ; He, Jiang 190 ; Pim van der Harst 191 ; Elliott, Paul 192 ; Chambers, John C 193 ; Takeuchi, Fumihiko 189 ; Johnson, Andrew D 194 ; Sanghera, Dharambir K 195 ; Jern, Christina 196 ; Strbian, Daniel 197 ; Fernandez-Cadenas, Israel 117 ; Longstreth, W T, Jr 198 ; Rolfs, Arndt 109 ; Hata, Jun 159 ; Woo, Daniel 145 ; Rosand, Jonathan 106 ; Pare, Guillaume 107 ; Saleheen, Danish 199 ; Stefansson, Kari 200 ; Worrall, Bradford B 201 ; Kittner, Steven J 121 ; Howson, Joanna M M 202 ; Kamatani, Yoichiro 203 ; Dehghan, Abbas 204 ; Seldenrijk, Adrie 205 ; Morrison, Alanna C 3 ; Hamsten, Anders 59 ; Psaty, Bruce M 206 ; van Duijn, Cornelia M 207 ; Lawlor, Deborah A 92   VIAFID ORCID Logo  ; Mook-Kanamori, Dennis O 208 ; Bowden, Donald W 209 ; Schmidt, Helena 99 ; Wilson, James F 210   VIAFID ORCID Logo  ; Wilson, James G 211 ; Rotter, Jerome I 98 ; Wardlaw, Joanna M 212   VIAFID ORCID Logo  ; Deanfield, John 4 ; Halcox, Julian 213 ; Leo-Pekka Lyytikäinen 93   VIAFID ORCID Logo  ; Loeffler, Markus 14 ; Evans, Michele K 6 ; Debette, Stéphanie 15 ; Humphries, Steve E 214 ; Völker, Uwe 215 ; Gudnason, Vilmundur 10   VIAFID ORCID Logo  ; Hingorani, Aroon D 4 ; Björkegren, Johan L M 216 ; Casas, Juan P 9 ; Christopher J O’Donnell 217 

 Department of Epidemiology, University of North Carolina, Chapel Hill, NC, USA 
 Department of Pathology and Laboratory Medicine, University of California (UCLA), Los Angeles, Los Angeles, CA, USA 
 Human Genetics Center, Department of Epidemiology, Human Genetics, and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA 
 Institute of Cardiovascular Science, University College London, London, UK 
 Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, USA 
 Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA 
 Department of Genetic Epidemiology, University of Regensburg, Regensburg, Germany 
 Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands 
 Institute of Health Informatics, University College London, London, UK 
10  Icelandic Heart Association, Kopavogur, Iceland; University of Iceland, Reykjavik, Iceland 
11  Clinical Division of Neurogeriatrics, Department of Neurology, Medical University of Graz, Graz, Austria; Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria 
12  Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands 
13  Department of Biostatistical Sciences, Wake Forest University School of Medicine, Winston-Salem, NC, USA 
14  Institute for Medical Informatics, Statistics and Epidemiology, , University of Leipzig, Leipzig, Germany; LIFE Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany 
15  Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR 1219, CHU Bordeaux, Bordeaux, France 
16  Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland 
17  Department of Genetics and Genomic Sciences, The Icahn Institute for Genomics and Multiscale Biology Icahn School of Medicine at Mount Sinai, New York, NY, USA; Clinical Gene Networks AB, Stockholm, Sweden 
18  Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK 
19  Department of Internal Medicine, Section of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, RC, The Netherlands 
20  Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK; Medical Genetics Section, Centre for Genomic and Experimental Medicine, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK 
21  Population Sciences Branch, Division of Intramural Research, NHLBI, NIH, Framingham, MA, USA; National Heart, Lung and Blood Institute’s Intramural Research Program, Framingham Heart Study, Framingham, MA, USA 
22  Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA 
23  Department of Neurology, University Medicine Greifswald, Greifswald, Germany 
24  Department of Medicine, Columbia University, New York, NY, USA 
25  Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Biochemistry, Maastricht Centre for Systems Biology (MaCSBio), CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands 
26  Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA 
27  Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany; DZHK (German Center for Cardiovascular Research), partner site Greifswald, Greifswald, Germany 
28  Center for Diabetes Research, Wake Forest School of Medicine, Winston-Salem, NC, USA; Menzies Health Institute Queensland, Griffith University, Southport, QLD, Australia 
29  Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Internal Medicine, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, The Netherlands 
30  MRC Unit for Lifelong Health and Ageing at UCL, London, UK 
31  Department of Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands 
32  Department of Epidemiology, and School of Medicine, Division of Geriatric Medicine, University of Pittsburgh, Pittsburgh, PA, USA 
33  Department of Epidemiology and Public Health, University College London, London, UK 
34  Clinical Gene Networks AB, Stockholm, Sweden; Department of Pathophysiology, Institute of Biomedicine and Translation Medicine, University of Tartu, Biomeedikum, Tartu, Estonia; Department of Cardiac Surgery, Tartu University Hospital, Tartu, Estonia 
35  Cardiovascular Medicine Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; Department of Cell and Molecular Biology, National Bioinformatics Infrastructure Sweden, Science for Life Laboratory, Uppsala University, Uppsala, Sweden 
36  Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden 
37  Department of Pathology and Laboratory Medicine, University of California (UCLA), Los Angeles, Los Angeles, CA, USA; Department of Human Genetics, University of California (UCLA), Los Angeles, CA, USA 
38  Department of Psychiatry, EMGO Institute for Health and Care Research and Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, HL, The Netherlands 
39  Applied Sciences, Premier, Inc., Charlotte, NC, USA 
40  Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden; Department of Medicine, University of Verona, Verona, Italy 
41  Department of Medical Biotechnology and Translational Medicine, Università di Milano, Milan, Italy; Centro Cardiologico Monzino, IRCCS, Milan, Italy 
42  St. Elizabeth’s Medical Center, Tufts University School of Medicine, Boston, MA, USA 
43  LIFE Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany; Institute of Laboratory Medicine, University Hospital Munich, LMU Munich, Germany 
44  Centro Cardiologico Monzino, IRCCS, Milan, Italy; Dipartimento di Scienze Farmacologiche e Biomolecolari, Università di Milano, Milan, Italy 
45  Department of Clinical and Experimental Medicine, Internal Medicine, Angiology and Arteriosclerosis Diseases, University of Perugia, Perugia, Italy 
46  Centro Diagnostico Italiano, Milan, Italy 
47  Human Genetics Center, Department of Epidemiology, Human Genetics, and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA; Human Genome Sequencing Center, Baylor College of Medicine, Houston, TX, USA 
48  Department of Medicine, Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, CA, USA; Department of Medical Sciences, Molecular Epidemiology, Uppsala University, Uppsala, Sweden; Stanford Cardiovascular Institute, Stanford University, Stanford, CA, USA 
49  Centro Cardiologico Monzino, IRCCS, Milan, Italy 
50  Heart Center Leipzig, Leipzig, Germany 
51  Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR 1219, CHU Bordeaux, Bordeaux, France; Centre for Brain Research, Indian Institute of Science, Bangalore, India 
52  Stroke Research Group, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK 
53  Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK; Department of Psychology, University of Edinburgh, Edinburgh, UK 
54  Department of Cardiology, Leiden University Medical Center, Leiden, RC, The Netherlands 
55  Department of Internal Medicine, Radboud University Medical Center, Nijmegen, GA, The Netherlands 
56  Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK 
57  Department of Population and Quantitative Health Sciences, School of Medicine, Case Western Reserve University, Cleveland, OH, USA 
58  LIFE Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany; Institute for Laboratory Medicine, University of Leipzig, Leipzig, Germany 
59  Cardiovascular Medicine Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden 
60  Department of Biostatistics, University of Washington, Seattle, WA, USA 
61  Institute for Translational Genomics and Population Sciences, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA 
62  Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA 
63  Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, GA, The Netherlands 
64  Department of Medical Sciences, Cardiovascular Epidemiology, Uppsala University, Uppsala, Sweden 
65  Department of Genetics, University of North Carolina, Chapel Hill, NC, USA 
66  DZHK (German Center for Cardiovascular Research), partner site Greifswald, Greifswald, Germany; Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany 
67  Institute for Stroke and Dementia Research (ISD), University Hospital, Ludwig-Maximilians-University (LMU), Munich, Germany; Munich Cluster for Systems Neurology (SyNergy), Munich, Germany 
68  Department of Neurology, Center for Neurology and Neurosurgery, Johann Wolfgang Goethe-University, Frankfurt am Main, Germany 
69  Department of Epidemiology and Public Health, University College London, London, UK; Institute for Social and Economic Research, Essex University, Colchester, UK 
70  Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA; Data Tecnica International, Glen Echo, MD, USA 
71  Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland; Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland 
72  Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands; Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland 
73  Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands; Electrocardiography Research Group, School of Medicine, Universidad Industrial de Santander, Bucaramanga, Santander, Colombia 
74  Department of Genetics and Genomic Sciences, The Icahn Institute for Genomics and Multiscale Biology Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Psychiatry and Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Mental Illness Research Education and Clinical Center (MIRECC), James J. Peters VA Medical Center, Bronx, New York, NY, USA 
75  Population Health Research Institute, St George’s, University of London, London, UK 
76  Inserm U1167, Lille, France; Institut Pasteur de Lille, U1167, Lille, France; Université de Lille, U1167 - RID-AGE & Centre Hospitalier Universitaire de Lille, U1167, Lille, France 
77  Sorbonne Université, Cardiovascular Prevention Unit, Pitié Salpétrière Hospital, Paris, France 
78  Collaborative Health Studies Coordinating Center, Department of Biostatistics, University of Washington, Seattle, WA, USA 
79  Institute for Stroke and Dementia Research (ISD), University Hospital, Ludwig-Maximilians-University (LMU), Munich, Germany 
80  Foundation for Research in Health Exercise and Nutrition, Kuopio Research Institute of Exercise Medicine, Kuopio, Finland; Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland 
81  LIFE Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany; Institute of Laboratory Medicine, University of Leipzig, Leipzig, Germany; Institute of Clinical Chemistry and Laboratory Medicine, University Hospital Regensburg, Regensburg, Germany 
82  Clinical Division of Neurogeriatrics, Department of Neurology, Medical University of Graz, Graz, Austria 
83  Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands 
84  Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK 
85  Cardiovascular Medicine Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; Mental Health and Wellbeing, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK 
86  Department of Primary Care & Population Health, University College London, London, UK 
87  Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden 
88  Department of Internal Medicine, Section of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, RC, The Netherlands; Department of Cardiology, Leiden University Medical Center, Leiden, RC, The Netherlands 
89  Department of Neurology, Boston University School of Medicine, Boston, MA, USA 
90  Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio Campus, Kuopio, Finland 
91  Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, USA; Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA 
92  Population Health Science, Bristol Medical School, University of Bristol, Bristol, UK; MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK 
93  Department of Clinical Chemistry, Fimlab Laboratories, Tampere, Finland; Department of Clinical Chemistry, University of Tampere School of Medicine, Tampere, Finland 
94  Division of Cardiovascular Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden 
95  Genetics Institute, University College London, London, UK 
96  Departments of Medicine and Epidemiology, Johns Hopkins University, Baltimore, MD, USA 
97  National Heart, Lung and Blood Institute’s Intramural Research Program, Framingham Heart Study, Framingham, MA, USA; Section of Biomedical Genetics, School of Medicine, Boston University, Boston, MA, USA 
98  Institute for Translational Genomics and Population Sciences, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA; Department of Pediatrics, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA 
99  Institute of Molecular Biology and Biochemistry, Centre for Molecular Medicine, Medical University of Graz, Graz, Austria 
100  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 
101  INSERM U1219 Bordeaux Population Health Research Center, Bordeaux, France; University of Bordeaux, Bordeaux, France 
102  Stroke Research Group, Division of Clinical Neurosciences, University of Cambridge, Cambridge, UK 
103  Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; J. Philip Kistler Stroke Research Center, Department of Neurology, MGH, Boston, MA, USA 
104  Laboratory of Experimental Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, Netherlands 
105  deCODE genetics/AMGEN inc, Reykjavik, Iceland 
106  J. Philip Kistler Stroke Research Center, Department of Neurology, MGH, Boston, MA, USA; Center for Genomic Medicine, Massachusetts General Hospital (MGH), Boston, MA, USA; Program in Medical and Population Genetics, Broad Institute, Cambridge, MA, USA 
107  Population Health Research Institute, McMaster University, Hamilton, Canada 
108  Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan 
109  Albrecht Kossel Institute, University Clinic of Rostock, Rostock, Germany 
110  J. Philip Kistler Stroke Research Center, Department of Neurology, MGH, Boston, MA, USA; Department of Radiology, Massachusetts General Hospital, Harvard Medical School, AA Martinos Center for Biomedical Imaging, Boston, MA, USA 
111  Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, USA; Department of Biostatistics, University of Washington, Seattle, WA, USA 
112  Division of Neurology, Faculty of Medicine, Brain Research Center, University of British Columbia, Vancouver, Canada 
113  School of Life Science, University of Lincoln, Lincoln, UK 
114  Department of Cerebrovascular Diseases, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy 
115  Department of Neurology, Mayo Clinic Rochester, Rochester, MN, USA 
116  MRC/BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK; The National Institute for Health Research Blood and Transplant Research Unit in Donor Health and Genomics, University of Cambridge, Cambridge, UK 
117  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 
118  Children’s Research Institute, Children’s National Medical Center, Washington, DC, USA; Center for Translational Science, George Washington University, Washington, DC, USA 
119  Harvard Medical School, Boston, MA, USA; Division of Preventive Medicine, Brigham and Women’s Hospital, Boston, MA, USA 
120  Department of Public Health Sciences, Center for Public Health Genomics, University of Virginia School of Medicine, Charlottesville, VA, USA 
121  Department of Neurology, University of Maryland School of Medicine and Baltimore VAMC, Baltimore, MD, USA 
122  Institute of Cardiovascular Research, Royal Holloway University of London, Egham, UK 
123  Department of Psychiatry,The 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 
124  MRC/BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK; The National Institute for Health Research Blood and Transplant Research Unit in Donor Health and Genomics, University of Cambridge, Cambridge, UK; Wellcome Trust Sanger Institute, Hinxton, UK 
125  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 
126  National Heart, Lung and Blood Institute’s Intramural Research Program, Framingham Heart Study, Framingham, MA, USA; Boston University School of Public Health, Boston, MA, USA 
127  Department of Immunology, Genetics and Pathology and Science for Life Laboratory, Uppsala University, Uppsala, Sweden 
128  MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, UK 
129  Department of Neurology and Stroke Center, Basel University Hospital, Basel, Switzerland; Neurorehabilitation Unit, University and University Center for Medicine of Aging and Rehabilitation Basel, Felix Platter Hospital, Basel, Switzerland 
130  Program in Medical and Population Genetics, Broad Institute, Cambridge, MA, USA; Department of Neurology, Yale University School of Medicine, New Haven, CT, USA 
131  Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA 
132  Neuroscience Institute, SF Medical Center, Trenton, NJ, USA 
133  Department of Medical Sciences, Molecular Epidemiology, Uppsala University, Uppsala, Sweden 
134  Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA 
135  Department of Neurology, Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, Leeds, UK 
136  National Institute for Health and Welfare, Helsinki, Finland; FIMM - Institute for Molecular Medicine Finland, Helsinki, Finland 
137  Public Health Stream, Hunter Medical Research Institute, New Lambton, Australia; Faculty of Health and Medicine, University of Newcastle, Newcastle, Australia 
138  School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA 
139  Aflac Cancer and Blood Disorder Center, Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA 
140  Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, USA 
141  Brown Foundation Institute of Molecular Medicine, University of Texas Health Science Center at Houston, Houston, TX, USA 
142  Neurovascular Research Group (NEUVAS), Neurology Department, Institut Hospital del Mar d’Investigació Mèdica, Universitat Autònoma de Barcelona, Barcelona, Spain 
143  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 
144  Department of Biology, East Carolina University, Greenville, NC, USA; Center for Health Disparities, East Carolina University, Greenville, NC, USA 
145  University of Cincinnati College of Medicine, Cincinnati, OH, USA 
146  RIKEN Center for Integrative Medical Sciences, Yokohama, Japan 
147  University of Colorado, Denver, CO, USA 
148  Department of Neurology, Radiology, and Biomedical Engineering, Washington University School of Medicine, St. Louis, MO, USA 
149  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 
150  University of Lille, INSERM U1171, CHU Lille, Lille, France 
151  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 
152  Cardiovascular Epidemiology Unit, Department Public Health & Primary Care, University of Cambridge, Cambridge, UK; Northern Institute for Cancer Research, Paul O’Gorman Building, Newcastle University, Newcastle, UK 
153  Department of Clinical Sciences Lund, Neurology, Lund University, Lund, Sweden; Department of Neurology and Rehabilitation Medicine, Skåne University Hospital, Lund, Sweden 
154  Bioinformatics Core Facility, University of Gothenburg, Gothenburg, Sweden 
155  University of Technology Sydney, Faculty of Health, Ultimo, Australia 
156  Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA 
157  Department of Neurology, Mayo Clinic, Jacksonville, FL, USA 
158  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, FL, USA 
159  Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan 
160  Population Health Research Institute, McMaster University, Hamilton, Canada; Clinical Research Facility, Department of Medicine, NUI Galway, Galway, Ireland 
161  Department of Neurology, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands 
162  Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK 
163  Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA; Department of Neurology, University Medicine Greifswald, Greifswald, Germany 
164  Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA 
165  Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK 
166  Department of Neurology, Miller School of Medicine, University of Miami, Miami, FL, USA 
167  Human Genetics Center, Department of Epidemiology, Human Genetics, and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA; Department of Allergy and Rheumatology, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan 
168  National Institute for Health and Welfare, Helsinki, Finland 
169  Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA 
170  University Medicine Greifswald, Institute for Community Medicine, SHIP-KEF, Greifswald, Germany 
171  Department of Neurology, Jagiellonian University, Krakow, Poland 
172  University of Edinburgh, Edinburgh, UK 
173  Department of Neurology, Justus Liebig University, Giessen, Germany 
174  Department of Clinical Neurosciences/Neurology, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden; Sahlgrenska University Hospital, Gothenburg, Sweden 
175  Stroke Division, Florey Institute of Neuroscience and Mental Health, Heidelberg, Australia; Austin Health, Department of Neurology, Heidelberg, Victoria, Australia 
176  School of Medicine, Dentistry and Nursing at the University of Glasgow, Glasgow, UK 
177  Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA 
178  Boston University School of Public Health, Boston, MA, USA 
179  Department of Human Genetics, McGill University, Montreal, Canada 
180  Department of Genetics and Genomic Sciences, The Icahn Institute for Genomics and Multiscale Biology Icahn School of Medicine at Mount Sinai, New York, NY, USA 
181  Sorbonne Universités, UPMC Univ. Paris 06, INSERM, UMR_S 1166, Team Genomics & Pathophysiology of Cardiovascular Diseases, Paris, France; ICAN, Institute for Cardiometabolism and Nutrition, Paris, France 
182  Department of Public Health Sciences, Center for Public Health Genomics, University of Virginia School of Medicine, Charlottesville, VA, USA; Department of Biomedical Engineering, University of Virginia, Charlottesville, VA, USA 
183  Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, USA; Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA; Seattle Epidemiologic Research and Information Center, VA Office of Research and Development, Seattle, WA, USA 
184  Program in Medical and Population Genetics, Broad Institute, Cambridge, MA, USA; Cardiovascular Research Center, Massachusetts General Hospital, Boston, MA, USA; Department of Medical Research, Bærum Hospital, Vestre Viken Hospital Trust, Rud, Norway 
185  Program in Medical and Population Genetics, Broad Institute, Cambridge, MA, USA 
186  Program in Medical and Population Genetics, Broad Institute, Cambridge, MA, USA; Cardiovascular Research Center, Massachusetts General Hospital, Boston, MA, USA 
187  Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore 
188  National Heart and Lung Institute, Imperial College London, London, UK 
189  Department of Gene Diagnostics and Therapeutics, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan 
190  Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA 
191  Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, RB, Netherlands 
192  Department of Epidemiology and Biostatistics, Imperial College London, MRC-PHE Centre for Environment and Health, School of Public Health, London, UK 
193  Department of Epidemiology & Biostatistics, Imperial College London, London, UK; Department of Cardiology, Ealing Hospital NHS Trust, Southall, UK 
194  National Heart, Lung and Blood Institute’s Intramural Research Program, Framingham Heart Study, Framingham, MA, USA 
195  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 
196  Department of Pathology and Genetics, Institute of Biomedicine, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden 
197  Department of Neurology, Helsinki University Hospital, Helsinki, Finland; Clinical Neurosciences, Neurology, University of Helsinki, Helsinki, Finland 
198  Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, USA; Department of Neurology, University of Washington, Seattle, WA, USA 
199  Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA 
200  deCODE genetics/AMGEN inc, Reykjavik, Iceland; Faculty of Medicine, University of Iceland, Reykjavik, Iceland 
201  Departments of Neurology and Public Health Sciences, University of Virginia School of Medicine, Charlottesville, VA, USA 
202  MRC/BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK 
203  Laboratory for Statistical Analysis, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan; Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan 
204  Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Epidemiology & Biostatistics, Imperial College London, London, UK 
205  GGZ inGeest and Amsterdam Public Health Research Institute, Department of Psychiatry, Amsterdam University Medical Center, Amsterdam, The Netherlands 
206  Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA; Cardiovascular Health Research Unit and Departments of Medicine, Epidemiology, and Health Services, University of Washington, Seattle, WA, USA 
207  Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands; Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK 
208  Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands; Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands 
209  Center for Human Genomics, Wake Forest University School of Medicine, Winston-Salem, NC, USA 
210  Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK; MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Western General Hospital, Edinburgh, UK 
211  Department of Physiology and Biophysics, University of Mississippi Medical Center, Jackson, MS, USA 
212  Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK; Centre for Clinical Brain Sciences, and UK Dementia Research Institute at the University of Edinburgh, Edinburgh, UK 
213  Swansea University Medical School, Swansea, UK 
214  Centre for Cardiovascular Genetics, Institute Cardiovascular Science, University College London, London, UK 
215  DZHK (German Center for Cardiovascular Research), partner site Greifswald, Greifswald, Germany; Interfaculty Institute for Genetics and Functional Genomics, University Medicine Greifswald, Greifswald, Germany 
216  Department of Genetics and Genomic Sciences, The Icahn Institute for Genomics and Multiscale Biology Icahn School of Medicine at Mount Sinai, New York, NY, USA; Clinical Gene Networks AB, Stockholm, Sweden; Department of Pathophysiology, Institute of Biomedicine and Translation Medicine, University of Tartu, Biomeedikum, Tartu, Estonia; Integrated Cardio Metabolic Centre, Department of Medicine, Karolinska Institutet, Karolinska Universitetssjukhuset, Huddinge, Sweden 
217  Intramural Administration Management Branch, National Heart, Lung, and Blood Institute, NIH, Bethesda, MD, USA; Cardiology Section, Boston Veteran’s Administration Healthcare, Boston, MA, USA; Harvard Medical School, Boston, MA, USA 
Pages
1-14
Publication year
2018
Publication date
Dec 2018
Publisher
Nature Publishing Group
e-ISSN
20411723
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
2148974534
Copyright
© 2018. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.