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54. Genetic invalidation of Lp-PLA2 as a therapeutic target: Large-scale study of five functional Lp-PLA2-lowering alleles

Author

Gregson, John M, Freitag, Daniel F, Surendran, Praveen, Stitziel, Nathan O, Chowdhury, Rajiv, Burgess, Stephen, Kaptoge, Stephen, Gao, Pei, Staley, James R, Willeit, Peter, Nielsen, Sune F, Caslake, Muriel, Trompet, Stella, Polfus, Linda M, Kuulasmaa, Kari, Kontto, Jukka, Perola, Markus, Blankenberg, Stefan, Veronesi, Giovanni, Gianfagna, Francesco, Männistö, Satu, Kimura, Akinori, Lin, Honghuang, Reilly, Dermot F, Gorski, Mathias, Mijatovic, Vladan, Munroe, Patricia B, Ehret, Georg B, Thompson, Alex, Uria-Nickelsen, Maria, Malarstig, Anders, Dehghan, Abbas, Vogt, Thomas F, Sasaoka, Taishi, Takeuchi, Fumihiko, Kato, Norihiro, Yamada, Yoshiji, Kee, Frank, Müller-Nurasyid, Martina, Ferrières, Jean, Arveiler, Dominique, Amouyel, Philippe, Salomaa, Veikko, Boerwinkle, Eric, Thompson, Simon G, Ford, Ian, Wouter Jukema, J, Sattar, Naveed, Packard, Chris J, Shafi Majumder, Abdulla al, Alam, Dewan S, Deloukas, Panos, Schunkert, Heribert, Samani, Nilesh J, Kathiresan, Sekar, Nordestgaard, Børge G, Saleheen, Danish, Howson, Joanna MM, Di Angelantonio, Emanuele, Butterworth, Adam S, and Danesh, John

Published
2017

62. Genetic invalidation of Lp-PLA2 as a therapeutic target:Large-scale study of five functional Lp-PLA2-lowering alleles

Author

Gregson, John M, Freitag, Daniel F, Surendran, Praveen, Stitziel, Nathan O, Chowdhury, Rajiv, Burgess, Stephen, Kaptoge, Stephen, Gao, Pei, Staley, James R, Willeit, Peter, Nielsen, Sune F, Caslake, Muriel, Trompet, Stella, Polfus, Linda M, Kuulasmaa, Kari, Kontto, Jukka, Perola, Markus, Blankenberg, Stefan, Veronesi, Giovanni, Gianfagna, Francesco, Männistö, Satu, Kimura, Akinori, Lin, Honghuang, Reilly, Dermot F, Gorski, Mathias, Mijatovic, Vladan, Munroe, Patricia B, Ehret, Georg B, Thompson, Alex, Uria-Nickelsen, Maria, Malarstig, Anders, Dehghan, Abbas, Vogt, Thomas F, Sasaoka, Taishi, Takeuchi, Fumihiko, Kato, Norihiro, Yamada, Yoshiji, Kee, Frank, Müller-Nurasyid, Martina, Ferrières, Jean, Arveiler, Dominique, Amouyel, Philippe, Salomaa, Veikko, Boerwinkle, Eric, Thompson, Simon G, Ford, Ian, Wouter Jukema, J, Sattar, Naveed, Packard, Chris J, Shafi Majumder, Abdulla Al, Alam, Dewan S, Deloukas, Panos, Schunkert, Heribert, Samani, Nilesh J, Kathiresan, Sekar, Nordestgaard, Børge G, Saleheen, Danish, Howson, Joanna Mm, Di Angelantonio, Emanuele, Butterworth, Adam S, Danesh, John, Gregson, John M, Freitag, Daniel F, Surendran, Praveen, Stitziel, Nathan O, Chowdhury, Rajiv, Burgess, Stephen, Kaptoge, Stephen, Gao, Pei, Staley, James R, Willeit, Peter, Nielsen, Sune F, Caslake, Muriel, Trompet, Stella, Polfus, Linda M, Kuulasmaa, Kari, Kontto, Jukka, Perola, Markus, Blankenberg, Stefan, Veronesi, Giovanni, Gianfagna, Francesco, Männistö, Satu, Kimura, Akinori, Lin, Honghuang, Reilly, Dermot F, Gorski, Mathias, Mijatovic, Vladan, Munroe, Patricia B, Ehret, Georg B, Thompson, Alex, Uria-Nickelsen, Maria, Malarstig, Anders, Dehghan, Abbas, Vogt, Thomas F, Sasaoka, Taishi, Takeuchi, Fumihiko, Kato, Norihiro, Yamada, Yoshiji, Kee, Frank, Müller-Nurasyid, Martina, Ferrières, Jean, Arveiler, Dominique, Amouyel, Philippe, Salomaa, Veikko, Boerwinkle, Eric, Thompson, Simon G, Ford, Ian, Wouter Jukema, J, Sattar, Naveed, Packard, Chris J, Shafi Majumder, Abdulla Al, Alam, Dewan S, Deloukas, Panos, Schunkert, Heribert, Samani, Nilesh J, Kathiresan, Sekar, Nordestgaard, Børge G, Saleheen, Danish, Howson, Joanna Mm, Di Angelantonio, Emanuele, Butterworth, Adam S, and Danesh, John

Published
2017

63. High-Sensitivity Cardiac Troponin, Statin Therapy, and Risk of Coronary Heart Disease

Author

Ford, Ian, Shah, Anoop S.V., Zhang, Ruiqi, McAllister, David A., Strachan, Fiona E., Caslake, Muriel, Newby, David E., Packard, Chris J., and Mills, Nicholas L.

Subjects
Cardiology and Cardiovascular Medicine
Abstract

Background Cardiac troponin is an independent predictor of cardiovascular mortality in individuals without symptoms or signs of cardiovascular disease. The mechanisms for this association are uncertain, and a role for troponin testing in the prevention of coronary heart disease has yet to be established. Objectives This study sought to determine whether troponin concentration could predict coronary events, be modified by statins, and reflect response to therapy in a primary prevention population. Methods WOSCOPS (West of Scotland Coronary Prevention Study) randomized men with raised low-density lipoprotein cholesterol and no history of myocardial infarction to pravastatin 40 mg once daily or placebo for 5 years. Plasma cardiac troponin I concentration was measured with a high-sensitivity assay at baseline and at 1 year in 3,318 participants. Results Baseline troponin was an independent predictor of myocardial infarction or death from coronary heart disease (hazard ratio [HR]: 2.3; 95% confidence interval [CI]: 1.4 to 3.7) for the highest (≥5.2 ng/l) versus lowest (≤3.1 ng/l) quarter of troponin (p < 0.001). There was a 5-fold greater reduction in coronary events when troponin concentrations decreased by more than a quarter, rather than increased by more than a quarter, for both placebo (HR: 0.29; 95% CI: 0.12 to 0.72 vs. HR: 1.95; 95% CI: 1.09 to 3.49; p < 0.001 for trend) and pravastatin (HR: 0.23; 95% CI: 0.10 to 0.53 vs. HR: 1.08; 95% CI: 0.53 to 2.21; p < 0.001 for trend). Pravastatin reduced troponin concentration by 13% (10% to 15%; placebo adjusted, p < 0.001) and doubled the number of men whose troponin fell more than a quarter (p < 0.001), which identified them as having the lowest risk for future coronary events (1.4% over 5 years). Conclusions Troponin concentration predicts coronary events, is reduced by statin therapy, and change at 1 year is associated with future coronary risk independent of cholesterol lowering. Serial troponin measurements have major potential to assess cardiovascular risk and monitor the impact of therapeutic interventions.

Published
2016
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64. Additional file 2: of Towards onset prevention of cognition decline in adults with Down syndrome (The TOP-COG study): A pilot randomised controlled trial

Author

Sally-Ann Cooper, Temitope Ademola, Caslake, Muriel, Douglas, Elizabeth, Evans, Jonathan, Greenlaw, Nicola, Haig, Caroline, Hassiotis, Angela, Jahoda, Andrew, McConnachie, Alex, Morrison, Jill, Ring, Howard, Starr, John, Stiles, Ciara, Chammy Sirisena, and Sullivan, Frank

Abstract

TOP-COG cognitive assessment tasks. (DOCX 15 kb)

Published
2016
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65. Additional file 3: of Towards onset prevention of cognition decline in adults with Down syndrome (The TOP-COG study): A pilot randomised controlled trial

Author

Sally-Ann Cooper, Temitope Ademola, Caslake, Muriel, Douglas, Elizabeth, Evans, Jonathan, Greenlaw, Nicola, Haig, Caroline, Hassiotis, Angela, Jahoda, Andrew, McConnachie, Alex, Morrison, Jill, Ring, Howard, Starr, John, Stiles, Ciara, Chammy Sirisena, and Sullivan, Frank

Abstract

CONSORT 2010 flow diagram. (DOC 48 kb)

Published
2016
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66. Additional file 1: of Towards onset prevention of cognition decline in adults with Down syndrome (The TOP-COG study): A pilot randomised controlled trial

Author

Sally-Ann Cooper, Temitope Ademola, Caslake, Muriel, Douglas, Elizabeth, Evans, Jonathan, Greenlaw, Nicola, Haig, Caroline, Hassiotis, Angela, Jahoda, Andrew, McConnachie, Alex, Morrison, Jill, Ring, Howard, Starr, John, Stiles, Ciara, Chammy Sirisena, and Sullivan, Frank

Abstract

CONSORT 2010 checklist. (DOC 218 kb)

Published
2016
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67. Additional file 4: of Towards onset prevention of cognition decline in adults with Down syndrome (The TOP-COG study): A pilot randomised controlled trial

Author

Sally-Ann Cooper, Temitope Ademola, Caslake, Muriel, Douglas, Elizabeth, Evans, Jonathan, Greenlaw, Nicola, Haig, Caroline, Hassiotis, Angela, Jahoda, Andrew, McConnachie, Alex, Morrison, Jill, Ring, Howard, Starr, John, Stiles, Ciara, Chammy Sirisena, and Sullivan, Frank

Abstract

Illustrative quotes from the nested qualitative study. (DOCX 16 kb)

Published
2016
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69. Trans-ancestry meta-analyses identify rare and common variants associated with blood pressure and hypertension

Author

Surendran, Praveen, Drenos, Fotios, Young, Robin, Warren, Helen, Cook, James P., Manning, Alisa K., Grarup, Niels, Sim, Xueling, Barnes, Daniel R., Witkowska, Kate, Staley, James R., Tragante, Vinicius, Tukiainen, Taru, Yaghootkar, Hanieh, Masca, Nicholas, Freitag, Daniel F., Ferreira, Teresa, Giannakopoulou, Olga, Tinker, Andrew, Harakalova, Magdalena, Mihailov, Evelin, Liu, Chunyu, Kraja, Aldi T., Nielsen, Sune Fallgaard, Rasheed, Asif, Samue, Maria, Zhao, Wei, Bonnycastle, Lori L., Jackson, Anne U., Narisu, Narisu, Swift, Amy J., Southam, Lorraine, Marten, Jonathan, Huyghe, Jeroen R., Stancakova, Alena, Fava, Cristiano, Ohlsson, Therese, Matchan, Angela, Stirrups, Kathleen E., Bork-Jensen, Jette, Gjesing, Anette P., Kontto, Jukka, Perola, Markus, Shaw-Hawkins, Susan, Havulinna, Aki S., Zhang, He, Donnelly, Louise A., Groves, Christopher J., Rayner, N. William, Neville, Matt J., Robertson, Neil R., Yiorkas, Andrianos M., Herzig, Karl-Heinz, Kajantie, Eero, Zhang, Weihua, Willems, Sara M., Lannfelt, Lars, Malerba, Giovanni, Soranzo, Nicole, Trabetti, Elisabetta, Verweij, Niek, Evangelou, Evangelos, Moayyeri, Alireza, Vergnaud, Anne-Claire, Nelson, Christopher P., Poveda, Alaitz, Varga, Tibor V., Caslake, Muriel, de Craen, Anton J. M., Trompet, Stella, Luan, Jian'an, Scott, Robert A., Harris, Sarah E., Liewald, David C. M., Marioni, Riccardo, Menni, Cristina, Farmaki, Aliki-Eleni, Hallmans, Goran, Renstrom, Frida, Huffman, Jennifer E., Hassinen, Maija, Burgess, Stephen, Vasan, Ramachandran S., Felix, Janine F., Uria-Nickelsen, Maria, Malarstign, Anders, Reilly, Dermot F., Hoek, Maarten, Vogt, Thomas F., Lin, Honghuang, Lieb, Wolfgang, Traylor, Matthew, Markus, Hugh S., Highland, Heather M., Justice, Anne E., Marouli, Eirini, Lindstrom, Jaana, Uusitupa, Matti, Komulainen, Pirjo, Lakka, Timo A., Rauramaa, Rainer, Polasek, Ozren, Rudan, Igor, Rolandsson, Olov, Franks, Paul W., Dedoussis, George, Spector, Timothy D., Jousilahti, Pekka, Mannisto, Satu, Deary, Ian J., Starr, John M., Langenberg, Claudia, Wareham, Nick J., Brown, Morris J., Dominiczak, Anna F., Connell, John M., Jukema, J. Wouter, Sattar, Naveed, Ford, Ian, Packard, Chris J., Esko, Tonu, Magi, Reedik, Metspalu, Andres, de Boer, Rudolf A., van der Meer, Peter, van der Harst, Pim, Gambaro, Giovanni, Ingelsson, Erik, Lind, Lars, de Bakker, Paul I. W., Numans, Mattijs E., Brandslund, Ivan, Christensen, Cramer, Petersen, Eva R. B., Korpi-Hyovalti, Eeva, Oksa, Heikki, Chambers, John C., Kooner, Jaspal S., Blakemore, Alexandra I. F., Franks, Steve, Jarvelin, Marjo-Riitta, Husemoen, Lise L., Linneberg, Allan, Skaaby, Tea, Thuesen, Betina, Karpe, Fredrik, Tuomilehto, Jaakko, Doney, Alex S. F., Morris, Andrew D., Palmer, Colin N. A., Holmen, Oddgeir Lingaas, Hveem, Kristian, Willer, Cristen J., Tuomi, Tiinamaija, Groop, Leif, Karajamaki, AnneMari, Palotie, Aarno, Ripatti, Samuli, Salomaa, Veikko, Alam, Dewan S., Majmnder, Abdulla Al Shafi, Di Angelantonio, Emanuele, Chowdhury, Rajiv, McCarthy, Mark I., Poulter, Neil, Stanton, Alice V., Sever, Peter, Amouyel, Philippe, Arveiler, Dominique, Blankenberg, Stefan, Ferrieres, Jean, Kee, Frank, Kuulasmaa, Kari, Muller-Nurasyid, Martina, Veronesi, Giovanni, Virtamo, Jarmo, Deloukas, Panos, Elliott, Paul, Zeggini, Eleftheria, Kathiresan, Sekar, Melander, Olle, Kuusisto, Johanna, Laakso, Markku, Padmanabhan, Sandosh, Porteous, David J., Hayward, Caroline, Scotland, Generation, Collins, Francis S., Mohlke, Karen L., Hansen, Torben, Pedersen, Oluf, Boehnke, Michael, Stringham, Heather M., Frossard, Philippe, Newton-Cheh, Christopher, Tobin, Martin D., Nordestgaard, Borge Gronne, Caulfield, Mark J., Mahajan, Anubha, Morris, Andrew P., Tomaszewski, Maciej, Samani, Nilesh J., Saleheen, Danish, Asselbergs, Folkert W., Lindgren, Cecilia M., Danesh, John, Wain, Louise V., Butterworth, Adam S., Howson, Joanna M. M., Munroe, Patricia B., Surendran, Praveen, Drenos, Fotios, Young, Robin, Warren, Helen, Cook, James P., Manning, Alisa K., Grarup, Niels, Sim, Xueling, Barnes, Daniel R., Witkowska, Kate, Staley, James R., Tragante, Vinicius, Tukiainen, Taru, Yaghootkar, Hanieh, Masca, Nicholas, Freitag, Daniel F., Ferreira, Teresa, Giannakopoulou, Olga, Tinker, Andrew, Harakalova, Magdalena, Mihailov, Evelin, Liu, Chunyu, Kraja, Aldi T., Nielsen, Sune Fallgaard, Rasheed, Asif, Samue, Maria, Zhao, Wei, Bonnycastle, Lori L., Jackson, Anne U., Narisu, Narisu, Swift, Amy J., Southam, Lorraine, Marten, Jonathan, Huyghe, Jeroen R., Stancakova, Alena, Fava, Cristiano, Ohlsson, Therese, Matchan, Angela, Stirrups, Kathleen E., Bork-Jensen, Jette, Gjesing, Anette P., Kontto, Jukka, Perola, Markus, Shaw-Hawkins, Susan, Havulinna, Aki S., Zhang, He, Donnelly, Louise A., Groves, Christopher J., Rayner, N. William, Neville, Matt J., Robertson, Neil R., Yiorkas, Andrianos M., Herzig, Karl-Heinz, Kajantie, Eero, Zhang, Weihua, Willems, Sara M., Lannfelt, Lars, Malerba, Giovanni, Soranzo, Nicole, Trabetti, Elisabetta, Verweij, Niek, Evangelou, Evangelos, Moayyeri, Alireza, Vergnaud, Anne-Claire, Nelson, Christopher P., Poveda, Alaitz, Varga, Tibor V., Caslake, Muriel, de Craen, Anton J. M., Trompet, Stella, Luan, Jian'an, Scott, Robert A., Harris, Sarah E., Liewald, David C. M., Marioni, Riccardo, Menni, Cristina, Farmaki, Aliki-Eleni, Hallmans, Goran, Renstrom, Frida, Huffman, Jennifer E., Hassinen, Maija, Burgess, Stephen, Vasan, Ramachandran S., Felix, Janine F., Uria-Nickelsen, Maria, Malarstign, Anders, Reilly, Dermot F., Hoek, Maarten, Vogt, Thomas F., Lin, Honghuang, Lieb, Wolfgang, Traylor, Matthew, Markus, Hugh S., Highland, Heather M., Justice, Anne E., Marouli, Eirini, Lindstrom, Jaana, Uusitupa, Matti, Komulainen, Pirjo, Lakka, Timo A., Rauramaa, Rainer, Polasek, Ozren, Rudan, Igor, Rolandsson, Olov, Franks, Paul W., Dedoussis, George, Spector, Timothy D., Jousilahti, Pekka, Mannisto, Satu, Deary, Ian J., Starr, John M., Langenberg, Claudia, Wareham, Nick J., Brown, Morris J., Dominiczak, Anna F., Connell, John M., Jukema, J. Wouter, Sattar, Naveed, Ford, Ian, Packard, Chris J., Esko, Tonu, Magi, Reedik, Metspalu, Andres, de Boer, Rudolf A., van der Meer, Peter, van der Harst, Pim, Gambaro, Giovanni, Ingelsson, Erik, Lind, Lars, de Bakker, Paul I. W., Numans, Mattijs E., Brandslund, Ivan, Christensen, Cramer, Petersen, Eva R. B., Korpi-Hyovalti, Eeva, Oksa, Heikki, Chambers, John C., Kooner, Jaspal S., Blakemore, Alexandra I. F., Franks, Steve, Jarvelin, Marjo-Riitta, Husemoen, Lise L., Linneberg, Allan, Skaaby, Tea, Thuesen, Betina, Karpe, Fredrik, Tuomilehto, Jaakko, Doney, Alex S. F., Morris, Andrew D., Palmer, Colin N. A., Holmen, Oddgeir Lingaas, Hveem, Kristian, Willer, Cristen J., Tuomi, Tiinamaija, Groop, Leif, Karajamaki, AnneMari, Palotie, Aarno, Ripatti, Samuli, Salomaa, Veikko, Alam, Dewan S., Majmnder, Abdulla Al Shafi, Di Angelantonio, Emanuele, Chowdhury, Rajiv, McCarthy, Mark I., Poulter, Neil, Stanton, Alice V., Sever, Peter, Amouyel, Philippe, Arveiler, Dominique, Blankenberg, Stefan, Ferrieres, Jean, Kee, Frank, Kuulasmaa, Kari, Muller-Nurasyid, Martina, Veronesi, Giovanni, Virtamo, Jarmo, Deloukas, Panos, Elliott, Paul, Zeggini, Eleftheria, Kathiresan, Sekar, Melander, Olle, Kuusisto, Johanna, Laakso, Markku, Padmanabhan, Sandosh, Porteous, David J., Hayward, Caroline, Scotland, Generation, Collins, Francis S., Mohlke, Karen L., Hansen, Torben, Pedersen, Oluf, Boehnke, Michael, Stringham, Heather M., Frossard, Philippe, Newton-Cheh, Christopher, Tobin, Martin D., Nordestgaard, Borge Gronne, Caulfield, Mark J., Mahajan, Anubha, Morris, Andrew P., Tomaszewski, Maciej, Samani, Nilesh J., Saleheen, Danish, Asselbergs, Folkert W., Lindgren, Cecilia M., Danesh, John, Wain, Louise V., Butterworth, Adam S., Howson, Joanna M. M., and Munroe, Patricia B.

Abstract

High blood pressure is a major risk factor for cardiovascular disease and premature death. However, there is limited knowledge on specific causal genes and pathways. To better understand the genetics of blood pressure, we genotyped 242,296 rare, low frequency and common genetic variants in up to 192,763 individuals and used similar to 155,063 samples for independent replication. We identified 30 new blood pressure- or hypertension-associated genetic regions in the general population, including 3 rare missense variants in RBM47, COL21A1 and RRAS with larger effects (>1.5 mm Hg/allele) than common variants. Multiple rare nonsense and missense variant associations were found in A2ML1, and a low-frequency nonsense variant in ENPEP was identified. Our data extend the spectrum of allelic variation underlying blood pressure traits and hypertension, provide new insights into the pathophysiology of hypertension and indicate new targets for clinical intervention.

Published
2016
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70. A genomic approach to therapeutic target validation identifies a glucose-lowering GLP1R variant protective for coronary heart disease

Author

Scott, Robert A., Freitag, Daniel F., Li, Li, Chu, Audrey Y., Surendran, Praveen, Young, Robin, Grarup, Niels, Stancakova, Alena, Chen, Yuning, Varga, Tibor V., Yaghootkar, Hanieh, Luan, Jian'an, Zhao, Jing Hua, Willems, Sara M., Wessel, Jennifer, Wang, Shuai, Maruthur, Nisa, Michailidou, Kyriaki, Pirie, Ailith, van der Lee, Sven J., Gillson, Christopher, Al Olama, Ali Amin, Amouyel, Philippe, Arriola, Larraitz, Arveiler, Dominique, Aviles-Olmos, Iciar, Balkau, Beverley, Barricarte, Aurelio, Barroso, Ines, Garcia, Sara Benlloch, Bis, Joshua C., Blankenberg, Stefan, Boehnke, Michael, Boeing, Heiner, Boerwinkle, Eric, Borecki, Ingrid B., Bork-Jensen, Jette, Bowden, Sarah, Caldas, Carlos, Caslake, Muriel, Cupples, L. Adrienne, Cruchaga, Carlos, Czajkowski, Jacek, den Hoed, Marcel, Dunn, Janet A., Earl, Helena M., Ehret, Georg B., Ferrannini, Ele, Ferrieres, Jean, Foltynie, Thomas, Ford, Ian, Forouhi, Nita G., Gianfagna, Francesco, Gonzalez, Carlos, Grioni, Sara, Hiller, Louise, Jansson, Jan-Håkan, Jorgensen, Marit E., Jukema, J. Wouter, Kaaks, Rudolf, Kee, Frank, Kerrison, Nicola D., Key, Timothy J., Kontto, Jukka, Kote-Jarai, Zsofia, Kraja, Aldi T., Kuulasmaa, Kari, Kuusisto, Johanna, Linneberg, Allan, Liu, Chunyu, Marenne, Galle, Mohlke, Karen L., Morris, Andrew P., Muir, Kenneth, Mueller-Nurasyid, Martina, Munroe, Patricia B., Navarro, Carmen, Nielsen, Sune F., Nilsson, Peter M., Nordestgaard, Borge G., Packard, Chris J., Palli, Domenico, Panico, Salvatore, Peloso, Gina M., Perola, Markus, Peters, Annette, Poole, Christopher J., Quiros, J. Ramn, Rolandsson, Olov, Sacerdote, Carlotta, Salomaa, Veikko, Sanchez, Mara-Jose, Sattar, Naveed, Sharp, Stephen J., Sims, Rebecca, Slimani, Nadia, Smith, Jennifer A., Thompson, Deborah J., Trompet, Stella, Tumino, Rosario, van der A, Daphne L., van der Schouw, Yvonne T., Virtamo, Jarmo, Walker, Mark, Walter, Klaudia, Abraham, Jean E., Amundadottir, Laufey T., Aponte, Jennifer L., Butterworth, Adams., Dupuis, Josee, Easton, Douglas F., Eeles, Rosalind A., Erdmann, Jeanette, Franks, Paul W., Frayling, Timothy M., Hansen, Torben, Howson, Joanna M. M., Jorgensen, Torben, Kooner, Jaspal, Laakso, Markku, Langenberg, Claudia, McCarthy, Mark I., Pankow, James S., Pedersen, Oluf, Riboli, Elio, Rotter, Jerome I., Saleheen, Danish, Samani, Nilesh J., Schunkert, Heribert, Vollenweider, Peter, O'Rahilly, Stephen, Deloukas, Panos, Danesh, John, Goodarzi, Mark O., Kathiresan, Sekar, Meigs, James B., Ehm, Margaret G., Wareham, Nicholas J., Waterworth, Dawn M., Scott, Robert A., Freitag, Daniel F., Li, Li, Chu, Audrey Y., Surendran, Praveen, Young, Robin, Grarup, Niels, Stancakova, Alena, Chen, Yuning, Varga, Tibor V., Yaghootkar, Hanieh, Luan, Jian'an, Zhao, Jing Hua, Willems, Sara M., Wessel, Jennifer, Wang, Shuai, Maruthur, Nisa, Michailidou, Kyriaki, Pirie, Ailith, van der Lee, Sven J., Gillson, Christopher, Al Olama, Ali Amin, Amouyel, Philippe, Arriola, Larraitz, Arveiler, Dominique, Aviles-Olmos, Iciar, Balkau, Beverley, Barricarte, Aurelio, Barroso, Ines, Garcia, Sara Benlloch, Bis, Joshua C., Blankenberg, Stefan, Boehnke, Michael, Boeing, Heiner, Boerwinkle, Eric, Borecki, Ingrid B., Bork-Jensen, Jette, Bowden, Sarah, Caldas, Carlos, Caslake, Muriel, Cupples, L. Adrienne, Cruchaga, Carlos, Czajkowski, Jacek, den Hoed, Marcel, Dunn, Janet A., Earl, Helena M., Ehret, Georg B., Ferrannini, Ele, Ferrieres, Jean, Foltynie, Thomas, Ford, Ian, Forouhi, Nita G., Gianfagna, Francesco, Gonzalez, Carlos, Grioni, Sara, Hiller, Louise, Jansson, Jan-Håkan, Jorgensen, Marit E., Jukema, J. Wouter, Kaaks, Rudolf, Kee, Frank, Kerrison, Nicola D., Key, Timothy J., Kontto, Jukka, Kote-Jarai, Zsofia, Kraja, Aldi T., Kuulasmaa, Kari, Kuusisto, Johanna, Linneberg, Allan, Liu, Chunyu, Marenne, Galle, Mohlke, Karen L., Morris, Andrew P., Muir, Kenneth, Mueller-Nurasyid, Martina, Munroe, Patricia B., Navarro, Carmen, Nielsen, Sune F., Nilsson, Peter M., Nordestgaard, Borge G., Packard, Chris J., Palli, Domenico, Panico, Salvatore, Peloso, Gina M., Perola, Markus, Peters, Annette, Poole, Christopher J., Quiros, J. Ramn, Rolandsson, Olov, Sacerdote, Carlotta, Salomaa, Veikko, Sanchez, Mara-Jose, Sattar, Naveed, Sharp, Stephen J., Sims, Rebecca, Slimani, Nadia, Smith, Jennifer A., Thompson, Deborah J., Trompet, Stella, Tumino, Rosario, van der A, Daphne L., van der Schouw, Yvonne T., Virtamo, Jarmo, Walker, Mark, Walter, Klaudia, Abraham, Jean E., Amundadottir, Laufey T., Aponte, Jennifer L., Butterworth, Adams., Dupuis, Josee, Easton, Douglas F., Eeles, Rosalind A., Erdmann, Jeanette, Franks, Paul W., Frayling, Timothy M., Hansen, Torben, Howson, Joanna M. M., Jorgensen, Torben, Kooner, Jaspal, Laakso, Markku, Langenberg, Claudia, McCarthy, Mark I., Pankow, James S., Pedersen, Oluf, Riboli, Elio, Rotter, Jerome I., Saleheen, Danish, Samani, Nilesh J., Schunkert, Heribert, Vollenweider, Peter, O'Rahilly, Stephen, Deloukas, Panos, Danesh, John, Goodarzi, Mark O., Kathiresan, Sekar, Meigs, James B., Ehm, Margaret G., Wareham, Nicholas J., and Waterworth, Dawn M.

Abstract

Regulatory authorities have indicated that new drugs to treat type 2 diabetes (T2D) should not be associated with an unacceptable increase in cardiovascular risk. Human genetics may be able to guide development of antidiabetic therapies by predicting cardiovascular and other health endpoints. We therefore investigated the association of variants in six genes that encode drug targets for obesity or T2D with a range of metabolic traits in up to 11,806 individuals by targeted exome sequencing and follow-up in 39,979 individuals by targeted genotyping, with additional in silico follow-up in consortia. We used these data to first compare associations of variants in genes encoding drug targets with the effects of pharmacological manipulation of those targets in clinical trials. We then tested the association of those variants with disease outcomes, including coronary heart disease, to predict cardiovascular safety of these agents. A low-frequency missense variant (Ala316Thr; rs10305492) in the gene encoding glucagon-like peptide-1 receptor (GLP1R), the target of GLP1R agonists, was associated with lower fasting glucose and T2D risk, consistent with GLP1R agonist therapies. The minor allele was also associated with protection against heart disease, thus providing evidence that GLP1R agonists are not likely to be associated with an unacceptable increase in cardiovascular risk. Our results provide an encouraging signal that these agents may be associated with benefit, a question currently being addressed in randomized controlled trials. Genetic variants associated with metabolic traits and multiple disease outcomes can be used to validate therapeutic targets at an early stage in the drug development process.

Published
2016
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71. A genomic approach to therapeutic target validation identifies a glucose-lowering GLP1R variant protective for coronary heart disease

Author

JC onderzoeksprogramma Cardiovasculaire Epidemiologie, Circulatory Health, Cardiovasculaire Epidemiologie, Scott, Robert A, Freitag, Daniel F, Li, Li, Chu, Audrey Y, Surendran, Praveen, Young, Robin, Grarup, Niels, Stancáková, Alena, Chen, Yuning, Varga, Tibor V, Yaghootkar, Hanieh, Luan, Jian'an, Zhao, Jing Hua, Willems, Sara M, Wessel, Jennifer, Wang, Shuai, Maruthur, Nisa, Michailidou, Kyriaki, Pirie, Ailith, van der Lee, Sven J, Gillson, Christopher, Al Olama, Ali Amin, Amouyel, Philippe, Arriola, Larraitz, Arveiler, Dominique, Aviles-Olmos, Iciar, Balkau, Beverley, Barricarte, Aurelio, Barroso, Inês, Garcia, Sara Benlloch, Bis, Joshua C, Blankenberg, Stefan, Boehnke, Michael, Boeing, Heiner, Boerwinkle, Eric, Borecki, Ingrid B, Bork-Jensen, Jette, Bowden, Sarah, Caldas, Carlos, Caslake, Muriel, Cupples, L Adrienne, Cruchaga, Carlos, Czajkowski, Jacek, den Hoed, Marcel, Dunn, Janet A, Earl, Helena M, Ehret, Georg B, Ferrannini, Ele, Ferrieres, Jean, van der Schouw, Yvonne T, CVD50 consortium, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, Circulatory Health, Cardiovasculaire Epidemiologie, Scott, Robert A, Freitag, Daniel F, Li, Li, Chu, Audrey Y, Surendran, Praveen, Young, Robin, Grarup, Niels, Stancáková, Alena, Chen, Yuning, Varga, Tibor V, Yaghootkar, Hanieh, Luan, Jian'an, Zhao, Jing Hua, Willems, Sara M, Wessel, Jennifer, Wang, Shuai, Maruthur, Nisa, Michailidou, Kyriaki, Pirie, Ailith, van der Lee, Sven J, Gillson, Christopher, Al Olama, Ali Amin, Amouyel, Philippe, Arriola, Larraitz, Arveiler, Dominique, Aviles-Olmos, Iciar, Balkau, Beverley, Barricarte, Aurelio, Barroso, Inês, Garcia, Sara Benlloch, Bis, Joshua C, Blankenberg, Stefan, Boehnke, Michael, Boeing, Heiner, Boerwinkle, Eric, Borecki, Ingrid B, Bork-Jensen, Jette, Bowden, Sarah, Caldas, Carlos, Caslake, Muriel, Cupples, L Adrienne, Cruchaga, Carlos, Czajkowski, Jacek, den Hoed, Marcel, Dunn, Janet A, Earl, Helena M, Ehret, Georg B, Ferrannini, Ele, Ferrieres, Jean, van der Schouw, Yvonne T, and CVD50 consortium

Published
2016

72. Does high-density lipoprotein protect vascular function in healthy pregnancy?

Author

Sulaiman, Wan N Wan, Caslake, Muriel J, Delles, Christian, Karlsson, Helen, Mulder, Monique T, Graham, Delyth, Freeman, Dilys J, Sulaiman, Wan N Wan, Caslake, Muriel J, Delles, Christian, Karlsson, Helen, Mulder, Monique T, Graham, Delyth, and Freeman, Dilys J

Abstract

The maternal adaptation to pregnancy includes hyperlipidaemia, oxidative stress and chronic inflammation. In non-pregnant individuals, these processes are usually associated with poor vascular function. However, maternal vascular function is enhanced in pregnancy. It is not understood how this is achieved in the face of the adverse metabolic and inflammatory environment. Research into cardiovascular disease demonstrates that plasma HDL (high-density lipoprotein), by merit of its functionality rather than its plasma concentration, exerts protective effects on the vascular endothelium. HDL has vasodilatory, antioxidant, anti-thrombotic and anti-inflammatory effects, and can protect against endothelial cell damage. In pregnancy, the plasma HDL concentration starts to rise at 10 weeks of gestation, peaking at 20 weeks. The initial rise in plasma HDL occurs around the time of the establishment of the feto-placental circulation, a time when the trophoblast plugs in the maternal spiral arteries are released, generating oxidative stress. Thus there is the intriguing possibility that new HDL of improved function is synthesized around the time of the establishment of the feto-placental circulation. In obese pregnancy and, to a greater extent, in pre-eclampsia, plasma HDL levels are significantly decreased and maternal vascular function is reduced. Wire myography studies have shown an association between the plasma content of apolipoprotein AI, the major protein constituent of HDL, and blood vessel relaxation. These observations lead us to hypothesize that HDL concentration, and function, increases in pregnancy in order to protect the maternal vascular endothelium and that in pre-eclampsia this fails to occur., Funding agencies: Malaysian Ministry of Higher Education; grant EU-MASCARA from the European Commission [278249]; grant sysVASC from the European Commission [603288]

Published
2016
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75. Towards onset prevention of cognition decline in adults with Down syndrome (The TOP-COG study): A pilot randomised controlled trial

Author

Cooper, Sally-Ann, primary, Ademola, Temitope, additional, Caslake, Muriel, additional, Douglas, Elizabeth, additional, Evans, Jonathan, additional, Greenlaw, Nicola, additional, Haig, Caroline, additional, Hassiotis, Angela, additional, Jahoda, Andrew, additional, McConnachie, Alex, additional, Morrison, Jill, additional, Ring, Howard, additional, Starr, John, additional, Stiles, Ciara, additional, Sirisena, Chammy, additional, and Sullivan, Frank, additional

Published
2016
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79. Consumption of Fish Oil Providing Amounts of Eicosapentaenoic Acid and Docosahexaenoic Acid That Can Be Obtained from the Diet Reduces Blood Pressure in Adults with Systolic Hypertension: A Retrospective Analysis

Author

Minihane, Anne M, primary, Armah, Christopher K, additional, Miles, Elizabeth A, additional, Madden, Jacqueline M, additional, Clark, Allan B, additional, Caslake, Muriel J, additional, Packard, Chris J, additional, Kofler, Bettina M, additional, Lietz, Georg, additional, Curtis, Peter J, additional, Mathers, John C, additional, Williams, Christine M, additional, and Calder, Philip C, additional

Published
2016
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81. C-Reactive Protein, Fibrinogen, and Cardiovascular Disease Prediction

Author

Emerging Risk Factors Collaboration, Kaptoge, Stephen, Di Angelantonio, Emanuele, Pennells, Lisa, Wood, Angela M, White, Ian R, Gao, Pei, Walker, Matthew, Thompson, Alexander, Sarwar, Nadeem, Caslake, Muriel, Butterworth, Adam S, Amouyel, Philippe, Assmann, Gerd, Bakker, Stephan JL, Barr, Elizabeth LM, Barrett-Connor, Elizabeth, Benjamin, Emelia J, Björkelund, Cecilia, Brenner, Hermann, Brunner, Eric, Clarke, Robert, Cooper, Jackie A, Cremer, Peter, Cushman, Mary, Dagenais, Gilles R, D'Agostino, Ralph B, Dankner, Rachel, Davey-Smith, George, Deeg, Dorly, Dekker, Jacqueline M, Engström, Gunnar, Folsom, Aaron R, Fowkes, F Gerry R, Gallacher, John, Gaziano, J Michael, Giampaoli, Simona, Gillum, Richard F, Hofman, Albert, Howard, Barbara V, Ingelsson, Erik, Iso, Hiroyasu, Jørgensen, Torben, Kiechl, Stefan, Kitamura, Akihiko, Kiyohara, Yutaka, Koenig, Wolfgang, Kromhout, Daan, Kuller, Lewis H, Lawlor, Debbie A, Meade, Tom W, Nissinen, Aulikki, Nordestgaard, Børge G, Onat, Altan, Panagiotakos, Demosthenes B, Psaty, Bruce M, Rodriguez, Beatriz, Rosengren, Annika, Salomaa, Veikko, Kauhanen, Jussi, Salonen, Jukka T, Shaffer, Jonathan A, Shea, Steven, Ford, Ian, Stehouwer, Coen DA, Strandberg, Timo E, Tipping, Robert W, Tosetto, Alberto, Wassertheil-Smoller, Sylvia, Wennberg, Patrik, Westendorp, Rudi G, Whincup, Peter H, Wilhelmsen, Lars, Woodward, Mark, Lowe, Gordon DO, Wareham, Nicholas J, Khaw, Kay-Tee, Sattar, Naveed, Packard, Chris J, Gudnason, Vilmundur, Ridker, Paul M, Pepys, Mark B, Thompson, Simon G, and Danesh, John

Abstract

BACKGROUND: There is debate about the value of assessing levels of C-reactive protein (CRP) and other biomarkers of inflammation for the prediction of first cardiovascular events. METHODS: We analyzed data from 52 prospective studies that included 246,669 participants without a history of cardiovascular disease to investigate the value of adding CRP or fibrinogen levels to conventional risk factors for the prediction of cardiovascular risk. We calculated measures of discrimination and reclassification during follow-up and modeled the clinical implications of initiation of statin therapy after the assessment of CRP or fibrinogen. RESULTS: The addition of information on high-density lipoprotein cholesterol to a prognostic model for cardiovascular disease that included age, sex, smoking status, blood pressure, history of diabetes, and total cholesterol level increased the C-index, a measure of risk discrimination, by 0.0050. The further addition to this model of information on CRP or fibrinogen increased the C-index by 0.0039 and 0.0027, respectively (P

Published
2012

82. Lipoprotein-associated phospholipase A(2) and risk of coronary disease, stroke, and mortality: collaborative analysis of 32 prospective studies

Author

Thompson, Alexander, Gao, Pei, Orfei, Lia, Watson, Sarah, Di Angelantonio, Emanuele, Kaptoge, Stephen, Ballantyne, Christie, Cannon, Christopher P., Criqui, Michael, Cushman, Mary, Hofman, Albert, Packard, Chris, Thompson, Simon G., Collins, Rory, Danesh, John, Willeit, Johann, Kiechl, Stefan, Wiedemann, Christian, Psaty, Bruce, Furberg, Curt, Khaw, Kay-Tee, Sandhu, Manjinder, Benjamin, Emelia J., Vasan, Ramachandran S., Schnabel, Renate B., Oldgren, Jonas, Rossi, Gian Paolo, Cesari, Maurizio, Lenzini, Livia, Zanchetta, Mario, James, Stefan K., Rimm, Eric, Hatoum, Ida, Anderson, Jeffrey L., May, Heidi T., Home, Benjamin D., Carlquist, John F., Muhlestein, Joseph B., Koenig, Wolfgang, Hermann Brenner, Rothenbacher, Dietrich, Maerz, Winfried, Boehm, Bernhard, Winkelmann, Bernhard R., Winkler, Karl, Berglund, Goran, Persson, Margaretha, Roger, Veronique, Gerber, Yariv, Berger, Peter B., Brilakis, Emmanouil S., Mcconnell, Joseph P., Meisinger, Christa, Sacco, Ralph, Elkind, Mitchell, Talmud, Philippa J., O Donoghue, Michelle, Sabatine, Marc S., Morrow, David A., Caslake, Muriel, Braunwald, Eugene, Barrett-Connor, Elizabeth, Daniels, Lori B., Laughlin, Gail A., Kardys, Isabella, Witteman, Jacqueline C. M., Corsetti, James P., Rainwater, David L., Moss, Arthur J., Wassertheil-Smoller, Sylvia, Ridker, Paul, Nelson, Jeanenne J., Zariffa, Nevine, Zalewski, Andrew, and Walker, Mat

Subjects
Male, medicine.medical_specialty, Heart disease, Systole, Blood Pressure, Coronary Disease, 030204 cardiovascular system & hematology, Risk Assessment, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Darapladib, Internal medicine, medicine, Fast track — Articles, Humans, Myocardial infarction, Prospective Studies, Risk factor, Particle Size, 030304 developmental biology, Apolipoproteins B, 0303 health sciences, Framingham Risk Score, business.industry, Vascular disease, Lipoprotein-associated phospholipase A2, General Medicine, Middle Aged, medicine.disease, Lipids, 3. Good health, Lipoproteins, LDL, Stroke, Blood pressure, 1-Alkyl-2-acetylglycerophosphocholine Esterase, Cardiology, Linear Models, lipids (amino acids, peptides, and proteins), Female, business, Biomarkers
Abstract

Background Lipoprotein-associated phospholipase A(2) (Lp-PLA(2)), an inflammatory enzyme expressed in atherosclerotic plaques, is a therapeutic target being assessed in trials of vascular disease prevention. We investigated associations of circulating Lp-PLA(2) mass and activity with risk of coronary heart disease, stroke, and mortality under different circumstances. Methods With use of individual records from 79 036 participants in 32 prospective studies (yielding 17 722 incident fatal or non-fatal outcomes during 474 976 person-years at risk), we did a meta-analysis of within-study regressions to calculate risk ratios (RRs) per 1 SD higher value of Lp-PLA(2) or other risk factor. The primary outcome was coronary heart disease. Findings Lp-PLA(2) activity and mass were associated with each other (r=0.51, 95% CI 0.47-0.56) and proatherogenic lipids. We noted roughly log-linear associations of Lp-PLA(2) activity and mass with risk of coronary heart disease and vascular death. RRs, adjusted for conventional risk factors, were: 1.10 (95% CI 1.05-1.16) with Lp-PLA(2) activity and 1.11 (1.07-1.16) with Lp-PLA(2) mass for coronary heart disease; 1.08 (0.97-1.20) and 1.14 (1.02-1.27) for ischaemic stroke; 1.16 (1.09-1.24) and 1.13 (1.05-1.22) for vascular mortality; and 1.10 (1.04-1.17) and 1.10 (1.03-1.18) for non-vascular mortality, respectively. RRs with Lp-PLA(2) did not differ significantly in people with and without initial stable vascular disease, apart from for vascular death with Lp-PLA(2) mass. Adjusted RRs for coronary heart disease were 1.10 (1.02-1.18) with non-HDL cholesterol and 1.10 (1.00-1.21) with systolic blood pressure. Interpretation Lp-PLA(2) activity and mass each show continuous associations with risk of coronary heart disease, similar in magnitude to that with non-HDL cholesterol or systolic blood pressure in this population. Associations of Lp-PLA(2) mass and activity are not exclusive to vascular outcomes, and the vascular associations depend at least partly on lipids. Funding UK Medical Research Council, GlaxoSmithKline, and British Heart Foundation.

Published
2010

83. Genetic invalidation of Lp-PLA2 as a therapeutic target: Large-scale study of five functional Lp-PLA2-lowering alleles.

Author

Gregson, John M, Freitag, Daniel F, Surendran, Praveen, Stitziel, Nathan O, Chowdhury, Rajiv, Burgess, Stephen, Kaptoge, Stephen, Gao, Pei, Staley, James R, Willeit, Peter, Nielsen, Sune F, Caslake, Muriel, Trompet, Stella, Polfus, Linda M, Kuulasmaa, Kari, Kontto, Jukka, Perola, Markus, Blankenberg, Stefan, Veronesi, Giovanni, and Gianfagna, Francesco

Published
2017
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85. Toward onset prevention of cognitive decline in adults with Down syndrome (the TOP-COG study): study protocol for a randomized controlled trial

Author

Cooper, Sally-Ann, primary, Caslake, Muriel, additional, Evans, Jonathan, additional, Hassiotis, Angela, additional, Jahoda, Andrew, additional, McConnachie, Alex, additional, Morrison, Jill, additional, Ring, Howard, additional, Starr, John, additional, Stiles, Ciara, additional, and Sullivan, Frank, additional

Published
2014
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86. Maternal obesity is associated with the formation of small dense LDL and hypoadiponectinemia in the third trimester

Author

Meyer, Barbara J, Stewart, Frances M, Brown, Elizabeth A, Cooney, Josephine, Nilsson, Solveig, Olivecrona, Gunilla, Ramsay, Jane E, Griffin, Bruce A, Caslake, Muriel J, Freeman, Dilys J, Meyer, Barbara J, Stewart, Frances M, Brown, Elizabeth A, Cooney, Josephine, Nilsson, Solveig, Olivecrona, Gunilla, Ramsay, Jane E, Griffin, Bruce A, Caslake, Muriel J, and Freeman, Dilys J

Abstract

CONTEXT: Maternal obesity is associated with high plasma triglyceride, poor vascular function, and an increased risk for pregnancy complications. In normal-weight pregnant women, higher triglyceride is associated with increased small, dense low-density lipoprotein (LDL). HYPOTHESIS: In obese pregnancy, increased plasma triglyceride concentrations result in triglyceride enrichment of very low-density lipoprotein-1 particles and formation of small dense LDL via lipoprotein lipase. DESIGN: Women (n = 55) of body mass index of 18-46 kg/m(2) were sampled longitudinally at 12, 26, and 35 weeks' gestation and 4 months postnatally. SETTING: Women were recruited at hospital antenatal appointments, and study visits were in a clinical research suite. OUTCOME MEASURES: Plasma concentrations of lipids, triglyceride-rich lipoproteins, lipoprotein lipase mass, estradiol, steroid hormone binding globulin, insulin, glucose, leptin, and adiponectin were determined. RESULTS: Obese women commenced pregnancy with higher plasma triglyceride, reached the same maximum, and then returned to higher postnatal levels than normal-weight women. Estradiol response to pregnancy (trimester 1-3 incremental area under the curve) was positively associated with plasma triglyceride response (r(2) adjusted 25%, P <.001). In the third trimester, the proportion of small, dense LDL was 2-fold higher in obese women than normal-weight women [mean (SD) 40.7 (18.8) vs 21.9 (10.9)%, P =.014], and 35% of obese, 14% of overweight, and none of the normal-weight women displayed an atherogenic LDL subfraction phenotype. The small, dense LDL mass response to pregnancy was inversely associated with adiponectin response (17%, P =.013). CONCLUSIONS: Maternal obesity is associated with an atherogenic LDL subfraction phenotype and may provide a mechanistic link to poor vascular function and adverse pregnancy outcome.

Published
2013

87. C-reactive protein, fibrinogen, and cardiovascular disease prediction

Author

Kaptoge, Stephen, Di Angelantonio, Emanuele, Pennells, Lisa, Wood, Angela M., White, Ian R., Gao, Pei, Walker, Matthew, Thompson, Alexander, Sarwar, Nadeem, Caslake, Muriel, Butterworth, Adam S., Amouyel, Philippe, Assmann, Gerd, Bakker, Stephan J. L., Barr, Elizabeth L. M., Barrett-Connor, Elizabeth, Benjamin, Emilia J., Björkelund, Cecilia, Brenner, Hermann, Kaptoge, Stephen, Di Angelantonio, Emanuele, Pennells, Lisa, Wood, Angela M., White, Ian R., Gao, Pei, Walker, Matthew, Thompson, Alexander, Sarwar, Nadeem, Caslake, Muriel, Butterworth, Adam S., Amouyel, Philippe, Assmann, Gerd, Bakker, Stephan J. L., Barr, Elizabeth L. M., Barrett-Connor, Elizabeth, Benjamin, Emilia J., Björkelund, Cecilia, and Brenner, Hermann

Abstract

BackgroundThere is debate about the value of assessing levels of C-reactive protein (CRP) and other biomarkers of inflammation for the prediction of first cardiovascular events.MethodsWe analyzed data from 52 prospective studies that included 246,669 participants without a history of cardiovascular disease to investigate the value of adding CRP or fibrinogen levels to conventional risk factors for the prediction of cardiovascular risk. We calculated measures of discrimination and reclassification during follow-up and modeled the clinical implications of initiation of statin therapy after the assessment of CRP or fibrinogen.ResultsThe addition of information on high-density lipoprotein cholesterol to a prognostic model for cardiovascular disease that included age, sex, smoking status, blood pressure, history of diabetes, and total cholesterol level increased the C-index, a measure of risk discrimination, by 0.0050. The further addition to this model of information on CRP or fibrinogen increased the C-index by 0.0039 and 0.0027, respectively (P<0.001), and yielded a net reclassification improvement of 1.52% and 0.83%, respectively, for the predicted 10-year risk categories of “low” (<10%), “intermediate” (10% to <20%), and “high” (≥20%) (P<0.02 for both comparisons). We estimated that among 100,000 adults 40 years of age or older, 15,025 persons would initially be classified as being at intermediate risk for a cardiovascular event if conventional risk factors alone were used to calculate risk. Assuming that statin therapy would be initiated in accordance with Adult Treatment Panel III guidelines (i.e., for persons with a predicted risk of ≥20% and for those with certain other risk factors, such as diabetes, irrespective of their 10-year predicted risk), additional targeted assessment of CRP or fibrinogen levels in the 13,199 remaining participants at intermediate risk could help prevent approximately 30 additional

Published
2012

88. Lipid-Related Markers and Cardiovascular Disease Prediction

Author

Di Angelantonio, Emanuele, Gao, Pei, Pennells, Lisa, Kaptoge, Stephen, Caslake, Muriel, Thompson, Alexander, Butterworth, Adam S., Sarwar, Nadeem, Wormser, David, Saleheen, Danish, Ballantyne, Christie M., Psaty, Bruce M., Sundström, Johan, Ridker, Paul M., Nagel, Dorothea, Gillum, Richard F., Ford, Ian, Ducimetiere, Pierre, Kiechl, Stefan, Dullaart, Robin P. F., Assmann, Gerd, D'Agostino, Ralph B., Dagenais, Gilles R., Cooper, Jackie A., Kromhout, Daan, Onat, Altan, Tipping, Robert W., Gomez-de-la-Camara, Agustin, Rosengren, Annika, Sutherland, Susan E., Gallacher, John, Fowkes, F. Gerry R., Casiglia, Edoardo, Hofman, Albert, Salomaa, Veikko, Barrett-Connor, Elizabeth, Clarke, Robert, Brunner, Eric, Jukema, J. Wouter, Simons, Leon A., Sandhu, Manjinder, Wareham, Nicholas J., Khaw, Kay-Tee, Kauhanen, Jussi, Salonen, Jukka T., Howard, William J., Nordestgaard, Borge G., Wood, Angela M., Thompson, Simon G., Boekholdt, S. Matthijs, Sattar, Naveed, Packard, Chris, Gudnason, Vilmundur, Danesh, John, Di Angelantonio, Emanuele, Gao, Pei, Pennells, Lisa, Kaptoge, Stephen, Caslake, Muriel, Thompson, Alexander, Butterworth, Adam S., Sarwar, Nadeem, Wormser, David, Saleheen, Danish, Ballantyne, Christie M., Psaty, Bruce M., Sundström, Johan, Ridker, Paul M., Nagel, Dorothea, Gillum, Richard F., Ford, Ian, Ducimetiere, Pierre, Kiechl, Stefan, Dullaart, Robin P. F., Assmann, Gerd, D'Agostino, Ralph B., Dagenais, Gilles R., Cooper, Jackie A., Kromhout, Daan, Onat, Altan, Tipping, Robert W., Gomez-de-la-Camara, Agustin, Rosengren, Annika, Sutherland, Susan E., Gallacher, John, Fowkes, F. Gerry R., Casiglia, Edoardo, Hofman, Albert, Salomaa, Veikko, Barrett-Connor, Elizabeth, Clarke, Robert, Brunner, Eric, Jukema, J. Wouter, Simons, Leon A., Sandhu, Manjinder, Wareham, Nicholas J., Khaw, Kay-Tee, Kauhanen, Jussi, Salonen, Jukka T., Howard, William J., Nordestgaard, Borge G., Wood, Angela M., Thompson, Simon G., Boekholdt, S. Matthijs, Sattar, Naveed, Packard, Chris, Gudnason, Vilmundur, and Danesh, John

Abstract

Context The value of assessing various emerging lipid-related markers for prediction of first cardiovascular events is debated. Objective To determine whether adding information on apolipoprotein B and apolipoprotein A-I, lipoprotein(a), or lipoprotein-associated phospholipase A2 to total cholesterol and high-density lipoprotein cholesterol (HDL-C) improves cardiovascular disease (CVD) risk prediction. Design, Setting, and Participants Individual records were available for 165 544 participants without baseline CVD in 37 prospective cohorts (calendar years of recruitment: 1968-2007) with up to 15 126 incident fatal or nonfatal CVD outcomes (10 132 CHD and 4994 stroke outcomes) during a median follow-up of 10.4 years (interquartile range, 7.6-14 years). Main Outcome Measures Discrimination of CVD outcomes and reclassification of participants across predicted 10-year risk categories of low (<10%), intermediate (10%-<20%), and high (≥20%) risk. Results The addition of information on various lipid-related markers to total cholesterol, HDL-C, and other conventional risk factors yielded improvement in the model's discrimination: C-index change, 0.0006 (95% CI, 0.0002-0.0009) for the combination of apolipoprotein B and A-I; 0.0016 (95% CI, 0.0009-0.0023) for lipoprotein(a); and 0.0018 (95% CI, 0.0010-0.0026) for lipoprotein-associated phospholipase A2 mass. Net reclassification improvements were less than 1% with the addition of each of these markers to risk scores containing conventional risk factors. We estimated that for 100 000 adults aged 40 years or older, 15 436 would be initially classified at intermediate risk using conventional risk factors alone. Additional testing with a combination of apolipoprotein B and A-I would reclassify 1.1%; lipoprotein(a), 4.1%; and lipoprotein-associated phospholipase A2 mass, 2.7% of people to a 20% or higher predicted CVD risk category and, therefore, in need of statin treatment under Adult Treatment Panel III guidelines. C

Published
2012
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93. Apolipoprotein E genotype and the cardiovascular disease risk phenotype: Impact of sex and adiposity (the FINGEN study)

Author

Kofler, Bettina M., primary, Miles, Elizabeth A., additional, Curtis, Peter, additional, Armah, Christopher K., additional, Tricon, Sabine, additional, Grew, Jilly, additional, Napper, Frances L., additional, Farrell, Leslie, additional, Lietz, Georg, additional, Packard, Christopher J., additional, Caslake, Muriel J., additional, Mathers, John C., additional, Williams, Christine M., additional, Calder, Philip C., additional, and Minihane, Anne Marie, additional

Published
2012
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95. Genetic invalidation of Lp-PLA2as a therapeutic target: Large-scale study of five functional Lp-PLA2-lowering alleles

Author

Gregson, John M, Freitag, Daniel F, Surendran, Praveen, Stitziel, Nathan O, Chowdhury, Rajiv, Burgess, Stephen, Kaptoge, Stephen, Gao, Pei, Staley, James R, Willeit, Peter, Nielsen, Sune F, Caslake, Muriel, Trompet, Stella, Polfus, Linda M, Kuulasmaa, Kari, Kontto, Jukka, Perola, Markus, Blankenberg, Stefan, Veronesi, Giovanni, Gianfagna, Francesco, Männistö, Satu, Kimura, Akinori, Lin, Honghuang, Reilly, Dermot F, Gorski, Mathias, Mijatovic, Vladan, Munroe, Patricia B, Ehret, Georg B, Thompson, Alex, Uria-Nickelsen, Maria, Malarstig, Anders, Dehghan, Abbas, Vogt, Thomas F, Sasaoka, Taishi, Takeuchi, Fumihiko, Kato, Norihiro, Yamada, Yoshiji, Kee, Frank, Müller-Nurasyid, Martina, Ferrières, Jean, Arveiler, Dominique, Amouyel, Philippe, Salomaa, Veikko, Boerwinkle, Eric, Thompson, Simon G, Ford, Ian, Wouter Jukema, J, Sattar, Naveed, Packard, Chris J, Shafi Majumder, Abdulla al, Alam, Dewan S, Deloukas, Panos, Schunkert, Heribert, Samani, Nilesh J, Kathiresan, Sekar, Nordestgaard, Børge G, Saleheen, Danish, Howson, Joanna MM, Di Angelantonio, Emanuele, Butterworth, Adam S, and Danesh, John

Abstract

Aims Darapladib, a potent inhibitor of lipoprotein-associated phospholipase A2(Lp-PLA2), has not reduced risk of cardiovascular disease outcomes in recent randomized trials. We aimed to test whether Lp-PLA2enzyme activity is causally relevant to coronary heart disease.Methods In 72,657 patients with coronary heart disease and 110,218 controls in 23 epidemiological studies, we genotyped five functional variants: four rare loss-of-function mutations (c.109+2T > C (rs142974898), Arg82His (rs144983904), Val279Phe (rs76863441), Gln287Ter (rs140020965)) and one common modest-impact variant (Val379Ala (rs1051931)) in PLA2G7,the gene encoding Lp-PLA2. We supplemented de-novo genotyping with information on a further 45,823 coronary heart disease patients and 88,680 controls in publicly available databases and other previous studies. We conducted a systematic review of randomized trials to compare effects of darapladib treatment on soluble Lp-PLA2activity, conventional cardiovascular risk factors, and coronary heart disease risk with corresponding effects of Lp-PLA2-lowering alleles.Results Lp-PLA2activity was decreased by 64% (p= 2.4 × 10–25) with carriage of any of the four loss-of-function variants, by 45% (p< 10–300) for every allele inherited at Val279Phe, and by 2.7% (p= 1.9 × 10–12) for every allele inherited at Val379Ala. Darapladib 160 mg once-daily reduced Lp-PLA2activity by 65% (p< 10–300). Causal risk ratios for coronary heart disease per 65% lower Lp-PLA2activity were: 0.95 (0.88–1.03) with Val279Phe; 0.92 (0.74–1.16) with carriage of any loss-of-function variant; 1.01 (0.68–1.51) with Val379Ala; and 0.95 (0.89–1.02) with darapladib treatment.Conclusions In a large-scale human genetic study, none of a series of Lp-PLA2-lowering alleles was related to coronary heart disease risk, suggesting that Lp-PLA2is unlikely to be a causal risk factor.

Published
2017
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99. Lipoprotein-associated phospholipase A2, inflammatory biomarkers, and risk of cardiovascular disease in the Prospective Study of Pravastatin in the Elderly at Risk (PROSPER)

Author

Caslake, Muriel J., primary, Packard, Chris J., additional, Robertson, Michele, additional, Cooney, Josephine, additional, Nelson, Jeanenne J., additional, Ford, Ian, additional, Gaw, Allan, additional, Jukema, J. Wouter, additional, Macfarlane, Peter W., additional, Stott, David J., additional, and Shepherd, James, additional

Published
2010
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