Journal article

Multiancestry genome-wide association study of 520,000 subjects identifies 32 loci associated with stroke and stroke subtypes.

  • Malik R Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany.
  • Chauhan G Centre for Brain Research, Indian Institute of Science, Bangalore, India.
  • Traylor M INSERM U1219 Bordeaux Population Health Research Center, University of Bordeaux, France.
  • Sargurupremraj M Stroke Research Group, Division of Clinical Neurosciences, University of Cambridge, Cambridge, UK.
  • Okada Y Laboratory for Statistical Analysis, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan.
  • Mishra A Stroke Research Group, Division of Clinical Neurosciences, University of Cambridge, Cambridge, UK.
  • Rutten-Jacobs L INSERM U1219 Bordeaux Population Health Research Center, University of Bordeaux, France.
  • Giese AK Department of Neurology, Massachusetts General Hospital (MGH), Harvard Medical School, Boston, MA, USA.
  • van der Laan SW Laboratory of Experimental Cardiology, Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, University of Utrecht, Utrecht, the Netherlands.
  • Gretarsdottir S deCODE genetics/AMGEN Inc., Reykjavik, Iceland.
  • Anderson CD Center for Genomic Medicine, MGH, Boston, MA, USA.
  • Chong M Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada.
  • Adams HHH Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands.
  • Ago T Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
  • Almgren P Department of Clinical Sciences, Lund University, Malmö, Sweden.
  • Amouyel P INSERM, Institut Pasteur de Lille, LabEx DISTALZ-UMR1167, Risk Factors and Molecular Determinants of Aging-Related Diseases, Université Lille, Lille, France.
  • Ay H J. Philip Kistler Stroke Research Center, Department of Neurology, MGH, Boston, MA, USA.
  • Bartz TM Cardiovascular Health Research Unit, Departments of Biostatistics and Medicine, University of Washington, Seattle, WA, USA.
  • Benavente OR Division of Neurology, Faculty of Medicine, Brain Research Center, University of British Columbia, Vancouver, British Columbia, Canada.
  • Bevan S School of Life Science, University of Lincoln, Lincoln, UK.
  • Boncoraglio GB Department of Cerebrovascular Diseases, Fondazione IRCCS Istituto Neurologico 'Carlo Besta', Milan, Italy.
  • Brown RD Department of Neurology, Mayo Clinic Rochester, Rochester, MN, USA.
  • Butterworth AS MRC/BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.
  • Carrera C Neurovascular Research Laboratory, Vall d'Hebron Institut of Research, Neurology and Medicine Departments-Universitat Autònoma de Barcelona, Vall d'Hebrón Hospital, Barcelona, Spain.
  • Carty CL Children's Research Institute, Children's National Medical Center, Washington, DC, USA.
  • Chasman DI Division of Preventive Medicine, Brigham and Women's Hospital, Boston, MA, USA.
  • Chen WM Center for Public Health Genomics, Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA.
  • Cole JW Department of Neurology, University of Maryland School of Medicine and Baltimore VAMC, Baltimore, MD, USA.
  • Correa A Departments of Medicine, Pediatrics and Population Health Science, University of Mississippi Medical Center, Jackson, MS, USA.
  • Cotlarciuc I Institute of Cardiovascular Research, Royal Holloway University of London, London, UK, and Ashford and St Peters Hospital, Surrey, UK.
  • Cruchaga C Department of Psychiatry, Hope Center Program on Protein Aggregation and Neurodegeneration (HPAN), Washington University School of Medicine, St. Louis, MO, USA.
  • Danesh J MRC/BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.
  • de Bakker PIW Department of Medical Genetics, University Medical Center Utrecht, Utrecht, the Netherlands.
  • DeStefano AL Boston University School of Public Health, Boston, MA, USA.
  • den Hoed M Department of Immunology, Genetics and Pathology and Science for Life Laboratory, Uppsala University, Uppsala, Sweden.
  • Duan Q Department of Genetics, University of North Carolina, Chapel Hill, NC, USA.
  • Engelter ST Department of Neurology and Stroke Center, Basel University Hospital, Basel, Switzerland.
  • Falcone GJ Department of Neurology, Yale University School of Medicine, New Haven, CT, USA.
  • Gottesman RF Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
  • Grewal RP Neuroscience Institute, SF Medical Center, Trenton, NJ, USA.
  • Gudnason V Icelandic Heart Association Research Institute, Kopavogur, Iceland.
  • Gustafsson S Department of Medical Sciences, Molecular Epidemiology and Science for Life Laboratory, Uppsala University, Uppsala, Sweden.
  • Haessler J Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
  • Harris TB Laboratory of Epidemiology and Population Science, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA.
  • Hassan A Department of Neurology, Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
  • Havulinna AS National Institute for Health and Welfare, Helsinki, Finland.
  • Heckbert SR Department of Epidemiology, University of Washington, Seattle, WA, USA.
  • Holliday EG Public Health Stream, Hunter Medical Research Institute, New Lambton, New South Wales, Australia.
  • Howard G School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA.
  • Hsu FC Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA.
  • Hyacinth HI Aflac Cancer and Blood Disorder Center, Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA.
  • Ikram MA Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands.
  • Ingelsson E Department of Medicine, Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, CA, USA.
  • Irvin MR Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA.
  • Jian X Brown Foundation Institute of Molecular Medicine, University of Texas Health Science Center at Houston, Houston, TX, USA.
  • Jiménez-Conde J Neurovascular Research Group (NEUVAS), Neurology Department, Institut Hospital del Mar d'Investigació Mèdica, Universitat Autònoma de Barcelona, Barcelona, Spain.
  • Johnson JA Department of Pharmacotherapy and Translational Research and Center for Pharmacogenomics, University of Florida, College of Pharmacy, Gainesville, FL, USA.
  • Jukema JW Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands.
  • Kanai M Laboratory for Statistical Analysis, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan.
  • Keene KL Department of Biology, East Carolina University, Greenville, NC, USA.
  • Kissela BM University of Cincinnati College of Medicine, Cincinnati, OH, USA.
  • Kleindorfer DO University of Cincinnati College of Medicine, Cincinnati, OH, USA.
  • Kooperberg C Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
  • Kubo M RIKEN Center for Integrative Medical Sciences, Yokohama, Japan.
  • Lange LA Department of Medicine, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO, USA.
  • Langefeld CD Center for Public Health Genomics and Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA.
  • Langenberg C MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge, UK.
  • Launer LJ Intramural Research Program, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA.
  • Lee JM Department of Neurology, Radiology, and Biomedical Engineering, Washington University School of Medicine, St. Louis, MO, USA.
  • Lemmens R Department of Neurosciences, Experimental Neurology, KU Leuven-University of Leuven, Leuven, Belgium.
  • Leys D INSERM U 1171, CHU Lille, Université Lille, Lille, France.
  • Lewis CM Department of Medical and Molecular Genetics, King's College London, London, UK.
  • Lin WY MRC/BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.
  • Lindgren AG Department of Clinical Sciences Lund, Neurology, Lund University, Lund, Sweden.
  • Lorentzen E Bioinformatics Core Facility, University of Gothenburg, Gothenburg, Sweden.
  • Magnusson PK Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
  • Maguire J University of Technology Sydney, Faculty of Health, Ultimo, New South Wales, Australia.
  • Manichaikul A Center for Public Health Genomics, Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA.
  • McArdle PF Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA.
  • Meschia JF Department of Neurology, Mayo Clinic, Jacksonville, FL, USA.
  • Mitchell BD Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA.
  • Mosley TH Division of Geriatrics, School of Medicine, University of Mississippi Medical Center, Jackson, MS, USA.
  • Nalls MA Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA.
  • Ninomiya T Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
  • O'Donnell MJ Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada.
  • Psaty BM Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, USA.
  • Pulit SL Department of Medical Genetics, University Medical Center Utrecht, Utrecht, the Netherlands.
  • Rannikmäe K Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK.
  • Reiner AP Department of Epidemiology, University of Washington, Seattle, WA, USA.
  • Rexrode KM Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.
  • Rice K Department of Biostatistics, University of Washington, Seattle, WA, USA.
  • Rich SS Center for Public Health Genomics, Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA.
  • Ridker PM Division of Preventive Medicine, Brigham and Women's Hospital, Boston, MA, USA.
  • Rost NS Department of Neurology, Massachusetts General Hospital (MGH), Harvard Medical School, Boston, MA, USA.
  • Rothwell PM Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.
  • Rotter JI Institute for Translational Genomics and Population Sciences, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA.
  • Rundek T Department of Neurology, Miller School of Medicine, University of Miami, Miami, FL, USA.
  • Sacco RL Department of Neurology, Miller School of Medicine, University of Miami, Miami, FL, USA.
  • Sakaue S Department of Statistical Genetics, Osaka University Graduate School of Medicine, Osaka, Japan.
  • Sale MM Center for Public Health Genomics, University of Virginia, Charlottesville, VA, USA.
  • Salomaa V National Institute for Health and Welfare, Helsinki, Finland.
  • Sapkota BR Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
  • Schmidt R Department of Neurology, Medical University of Graz, Graz, Austria.
  • Schmidt CO Institute for Community Medicine, SHIP-KEF, University Medicine Greifswald, Greifswald, Germany.
  • Schminke U Department of Neurology, University Medicine Greifswald, Greifswald, Germany.
  • Sharma P Institute of Cardiovascular Research, Royal Holloway University of London, London, UK, and Ashford and St Peters Hospital, Surrey, UK.
  • Slowik A Department of Neurology, Jagiellonian University, Krakow, Poland.
  • Sudlow CLM Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK.
  • Tanislav C Department of Neurology, Justus Liebig University, Giessen, Germany.
  • Tatlisumak T Department of Clinical Neurosciences/Neurology, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
  • Taylor KD Institute for Translational Genomics and Population Sciences, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA.
  • Thijs VNS Stroke Division, Florey Institute of Neuroscience and Mental Health, University of Melbourne, Heidelberg, Victoria, Australia.
  • Thorleifsson G deCODE genetics/AMGEN Inc., Reykjavik, Iceland.
  • Thorsteinsdottir U deCODE genetics/AMGEN Inc., Reykjavik, Iceland.
  • Tiedt S Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany.
  • Trompet S Department of Internal Medicine, Section Gerontology and Geriatrics, Leiden University Medical Center, Leiden, the Netherlands.
  • Tzourio C Department of Neurology, Institute for Neurodegenerative Disease, Bordeaux University Hospital, Bordeaux, France.
  • van Duijn CM Genetic Epidemiology Unit, Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands.
  • Walters M School of Medicine, Dentistry and Nursing at the University of Glasgow, Glasgow, UK.
  • Wareham NJ MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge, UK.
  • Wassertheil-Smoller S Department of Epidemiology and Population Health, Albert Einstein College of Medicine, New York, NY, USA.
  • Wilson JG Department of Physiology and Biophysics, University of Mississippi Medical Center, Jackson, MS, USA.
  • Wiggins KL Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, USA.
  • Yang Q Boston University School of Public Health, Boston, MA, USA.
  • Yusuf S Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada.
  • Bis JC Department of Genetics and Genomic Sciences, Icahn Institute for Genomics and Multiscale Biology Icahn School of Medicine at Mount Sinai, New York, NY, USA.
  • Pastinen T UPMC Univ. Paris 06, INSERM, UMR_S 1166, Team Genomics & Pathophysiology of Cardiovascular Diseases, Sorbonne Universités, Paris, France.
  • Ruusalepp A Center for Public Health Genomics, University of Virginia, Charlottesville, VA, USA.
  • Schadt EE Department of Epidemiology, University of Washington, Seattle, WA, USA.
  • Koplev S UPMC Univ. Paris 06, INSERM, UMR_S 1166, Team Genomics & Pathophysiology of Cardiovascular Diseases, Sorbonne Universités, Paris, France.
  • Björkegren JLM Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, MA, USA.
  • Codoni V Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, MA, USA.
  • Civelek M Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, MA, USA.
  • Smith NL Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, MA, USA.
  • Trégouët DA Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore.
  • Christophersen IE National Heart and Lung Institute, Imperial College London, London, UK.
  • Roselli C Department of Gene Diagnostics and Therapeutics, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan.
  • Lubitz SA Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA.
  • Ellinor PT Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
  • Tai ES MRC-PHE Centre for Environment and Health, School of Public Health, Department of Epidemiology and Biostatistics and the NIHR Imperial Biomedical Research Centre, Imperial College London, London, UK.
  • Kooner JS Department of Epidemiology and Biostatistics, Imperial College London, London, UK.
  • Kato N Department of Gene Diagnostics and Therapeutics, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan.
  • He J Framingham Heart Study, Framingham, MA, USA.
  • van der Harst P Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
  • Elliott P Department of Clinical Sciences, Lund University, Malmö, Sweden.
  • Chambers JC Department of Pathology and Genetics, Institute of Biomedicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
  • Takeuchi F Department of Neurology, Helsinki University Hospital, Helsinki, Finland.
  • Johnson AD Neurovascular Research Laboratory, Vall d'Hebron Institut of Research, Neurology and Medicine Departments-Universitat Autònoma de Barcelona, Vall d'Hebrón Hospital, Barcelona, Spain.
  • Sanghera DK Department of Neurology, University of Maryland School of Medicine and Baltimore VAMC, Baltimore, MD, USA.
  • Melander O Framingham Heart Study, Framingham, MA, USA.
  • Jern C Brown Foundation Institute of Molecular Medicine, University of Texas Health Science Center at Houston, Houston, TX, USA.
  • Strbian D INSERM U1219 Bordeaux Population Health Research Center, University of Bordeaux, France.
  • Fernandez-Cadenas I MRC/BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.
  • Longstreth WT Laboratory for Statistical Analysis, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan.
  • Rolfs A Stroke Research Group, Division of Clinical Neurosciences, University of Cambridge, Cambridge, UK. stephanie.debette@u-bordeaux.fr.
  • Hata J Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany. martin.dichgans@med.uni-muenchen.de.
  • Woo D
  • Rosand J
  • Pare G
  • Hopewell JC
  • Saleheen D
  • Stefansson K
  • Worrall BB
  • Kittner SJ
  • Seshadri S
  • Fornage M
  • Markus HS
  • Howson JMM
  • Kamatani Y
  • Debette S
  • Dichgans M
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  • 2018-03-14
Published in:
  • Nature genetics. - 2018
English Stroke has multiple etiologies, but the underlying genes and pathways are largely unknown. We conducted a multiancestry genome-wide-association meta-analysis in 521,612 individuals (67,162 cases and 454,450 controls) and discovered 22 new stroke risk loci, bringing the total to 32. We further found shared genetic variation with related vascular traits, including blood pressure, cardiac traits, and venous thromboembolism, at individual loci (n = 18), and using genetic risk scores and linkage-disequilibrium-score regression. Several loci exhibited distinct association and pleiotropy patterns for etiological stroke subtypes. Eleven new susceptibility loci indicate mechanisms not previously implicated in stroke pathophysiology, with prioritization of risk variants and genes accomplished through bioinformatics analyses using extensive functional datasets. Stroke risk loci were significantly enriched in drug targets for antithrombotic therapy.
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