Discovery and systematic characterization of risk variants and genes for coronary artery disease in over a million participants.
Aragam KG., Jiang T., Goel A., Kanoni S., Wolford BN., Atri DS., Weeks EM., Wang M., Hindy G., Zhou W., Grace C., Roselli C., Marston NA., Kamanu FK., Surakka I., Venegas LM., Sherliker P., Koyama S., Ishigaki K., Åsvold BO., Brown MR., Brumpton B., de Vries PS., Giannakopoulou O., Giardoglou P., Gudbjartsson DF., Güldener U., Haider SMI., Helgadottir A., Ibrahim M., Kastrati A., Kessler T., Kyriakou T., Konopka T., Li L., Ma L., Meitinger T., Mucha S., Munz M., Murgia F., Nielsen JB., Nöthen MM., Pang S., Reinberger T., Schnitzler G., Smedley D., Thorleifsson G., von Scheidt M., Ulirsch JC., Biobank Japan None., EPIC-CVD None., Arnar DO., Burtt NP., Costanzo MC., Flannick J., Ito K., Jang D-K., Kamatani Y., Khera AV., Komuro I., Kullo IJ., Lotta LA., Nelson CP., Roberts R., Thorgeirsson G., Thorsteinsdottir U., Webb TR., Baras A., Björkegren JLM., Boerwinkle E., Dedoussis G., Holm H., Hveem K., Melander O., Morrison AC., Orho-Melander M., Rallidis LS., Ruusalepp A., Sabatine MS., Stefansson K., Zalloua P., Ellinor PT., Farrall M., Danesh J., Ruff CT., Finucane HK., Hopewell JC., Clarke R., Gupta RM., Erdmann J., Samani NJ., Schunkert H., Watkins H., Willer CJ., Deloukas P., Kathiresan S., Butterworth AS., CARDIoGRAMplusC4D Consortium None.
The discovery of genetic loci associated with complex diseases has outpaced the elucidation of mechanisms of disease pathogenesis. Here we conducted a genome-wide association study (GWAS) for coronary artery disease (CAD) comprising 181,522 cases among 1,165,690 participants of predominantly European ancestry. We detected 241 associations, including 30 new loci. Cross-ancestry meta-analysis with a Japanese GWAS yielded 38 additional new loci. We prioritized likely causal variants using functionally informed fine-mapping, yielding 42 associations with less than five variants in the 95% credible set. Similarity-based clustering suggested roles for early developmental processes, cell cycle signaling and vascular cell migration and proliferation in the pathogenesis of CAD. We prioritized 220 candidate causal genes, combining eight complementary approaches, including 123 supported by three or more approaches. Using CRISPR-Cas9, we experimentally validated the effect of an enhancer in MYO9B, which appears to mediate CAD risk by regulating vascular cell motility. Our analysis identifies and systematically characterizes >250 risk loci for CAD to inform experimental interrogation of putative causal mechanisms for CAD.