Open AccessAssociation Between APOL 1 Genotypes and Risk of Cardiovascular Disease in MESA (Multi‐Ethnic Study of Atherosclerosis)
Author(s) -
Chen Teresa K.,
Katz Ronit,
Estrella Michelle M.,
Gutierrez Orlando M.,
Kramer Holly,
Post Wendy S.,
Shlipak Michael G.,
Wassel Christina L.,
Peralta Carmen A.
Publication year - 2017
Publication title -
journal of the american heart association
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.494
H-Index - 85
ISSN - 2047-9980
DOI - 10.1161/jaha.117.007199
Subject(s) - medicine , hazard ratio , cardiology , renal function , confidence interval , kidney disease , heart failure , odds ratio , myocardial infarction , coronary artery disease
Background APOL 1 genetic variants confer an increased risk for kidney disease. Their associations with cardiovascular disease ( CVD ) are less certain. We aimed to compare the prevalence of subclinical CVD and incidence of atherosclerotic CVD and heart failure by APOL 1 genotypes among self‐identified black participants of MESA (Multi‐Ethnic Study of Atherosclerosis). Methods and Results Cross‐sectional associations of APOL 1 genotypes (high‐risk=2 alleles; low‐risk=0 or 1 allele) with coronary artery calcification, carotid‐intimal media thickness, and left ventricular mass were evaluated using logistic and linear regression. Longitudinal associations of APOL 1 genotypes with incident myocardial infarction, stroke, coronary heart disease, and congestive heart failure were examined using Cox regression. We adjusted for African ancestry, age, and sex. We also evaluated whether hypertension or kidney function markers explained the observed associations. Among 1746 participants with APOL 1 genotyping (mean age 62 years, 55% women, mean cystatin C–based estimated glomerular filtration rate 89 mL/min per 1.73 m 2 , 12% with albuminuria), 12% had the high‐risk genotypes. We found no difference in prevalence or severity of coronary artery calcification, carotid‐intimal media thickness, or left ventricular mass by APOL 1 genotypes. The APOL 1 high‐risk group was 82% more likely to develop incident heart failure compared with the low‐risk group (95% confidence interval, 1.01–3.28). Adjusting for hypertension (hazard ratio, 1.80; 95% confidence interval, 1.00–3.24) but not markers of kidney function (hazard ratio, 1.86; 95% confidence interval, 1.03–3.35) slightly attenuated this association. The APOL 1 high‐risk genotypes were not significantly associated with other clinical CVD outcomes. Conclusions Among blacks without baseline CVD , the APOL 1 high‐risk variants may be associated with increased risk for incident heart failure but not subclinical CVD or incident clinical atherosclerotic CVD .