Journal article
Association of APOL1 With Heart Failure With Preserved Ejection Fraction in Postmenopausal African American Women
JAMA cardiology, Vol.3(8), pp.712-720
08/01/2018
DOI: 10.1001/jamacardio.2018.1827
PMCID: PMC6143074
PMID: 29971324
Abstract
IMPORTANCE APOLI genotypes are associated with kidney diseases in African American individuals and may influence cardiovascular disease and mortality risk, but findings have been inconsistent.
OBJECTIVE To discern whether high-risk APOLI genotypes are associated with cardiovascular disease and stroke in postmenopausal African American women, who are at high risk for these outcomes.
DESIGN, SETTING, AND PARTICIPANTS The Women's Health Initiative is a prospective cohort that enrolled 161838 postmenopausal women into clinical trials and an observational study between 1993 and 1998. This study includes 11 137 African American women participants who had a clinical event from enrollment to June 2014. Data analyses were completed from January 2017 to August 2017.
EXPOSURES The variants of APOL1 were genotyped or imputed from whole-exome sequencing.
MAIN OUTCOMES AND MEASURES Incident coronary heart disease, stroke and heart failure subtypes, and overall and cause-specific mortality were adjudicated from hospital records and death certificates. Estimated incidence rates were determined for each outcome and hazard ratios (HR) and 95% CIs for the associations of APOL1 groups with outcomes.
RESULTS The mean (SD) age of participants was 61.7 (7.1) years. Carriers of high-risk APOL1 variants (n = 1370; 12.3%) had higher prevalence of hypertension, use of cholesterol-lowering medications, and reduced estimated glomerular filtration rate (eGFR). After a mean (SD) of 11.0 (3.6) years, carriers of high-risk APOL1 variants had a higher incidence rate of hospitalized heart failure with preserved ejection fraction (HFpEF) than low-risk carriers did but showed no differences for other outcomes. In adjusted models, there was a significant 58% increased hazard of hospitalized HFpEF (HR, 1.58 [95% CI, 1.03-2.41]) among carriers of high-risk APOL1 variants compared with carriers of low-risk APOLI variants. The association with HFpEF was attenuated (HR = 1.50 [95% CI, 0.98-2.30]) and no longer significant when adjusting for baseline eGFR.
CONCLUSIONS AND RELEVANCE Status as a carrier of a high-risk APOLI genotype was associated with HFpEF hospitalization among postmenopausal women, which is partly accounted for by baseline kidney function. These findings do not support an association of high-risk APOL1 genotypes with coronary heart disease, stroke, or mortality in postmenopausal African American women.
Details
- Title: Subtitle
- Association of APOL1 With Heart Failure With Preserved Ejection Fraction in Postmenopausal African American Women
- Creators
- Nora Franceschini - University of North Carolina at Chapel HillJeffrey B. Kopp - National Institute of Diabetes and Digestive and Kidney DiseasesAna Barac - MedStar Heart & Vascular InstituteLisa W. Martin - George Washington UniversityYun Li - University of North Carolina at Chapel HillHuijun Qian - University of North Carolina at Chapel HillAlex P. Reiner - University of WashingtonMartin Pollak - Harvard UniversityRobert B. Wallace - University of IowaWayne D. Rosamond - University of North Carolina at Chapel HillCheryl A. Winkler - Frederick National Laboratory for Cancer Research
- Resource Type
- Journal article
- Publication Details
- JAMA cardiology, Vol.3(8), pp.712-720
- DOI
- 10.1001/jamacardio.2018.1827
- PMID
- 29971324
- PMCID
- PMC6143074
- NLM abbreviation
- JAMA Cardiol
- ISSN
- 2380-6583
- eISSN
- 2380-6591
- Publisher
- Amer Medical Assoc
- Number of pages
- 9
- Grant note
- P30ES010126 / NATIONAL INSTITUTE OF ENVIRONMENTAL HEALTH SCIENCES; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Environmental Health Sciences (NIEHS) HHSN268201100046C; HSN268201100001C; HHSN268201100002C; HHSN268201100003C; HHSN268201100004C; HHSN271201100004C / US Department of Health and Human Services R01MD012765 / National Institute on Minority Health and Health Disparities; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute on Minority Health & Health Disparities (NIMHD) ZO1 DK043308 / National Institute of Diabetes and Digestive and Kidney Diseases Intramural Research Program; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Diabetes & Digestive & Kidney Diseases (NIDDK) ZIABC010022 / NATIONAL CANCER INSTITUTE; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Cancer Institute (NCI) R56 DK104806; R21 HL123677; R21 HL140385; R01 MD012765 / National Institutes of Health; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA ZIADK043308 / NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY DISEASES; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Diabetes & Digestive & Kidney Diseases (NIDDK) National Heart, Lung, and Blood Institute, National Institutes of Health; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Heart Lung & Blood Institute (NHLBI) R21HL140385 / NATIONAL HEART, LUNG, AND BLOOD INSTITUTE; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Heart Lung & Blood Institute (NHLBI)
- Language
- English
- Date published
- 08/01/2018
- Academic Unit
- Epidemiology; Injury Prevention Research Center; Internal Medicine
- Record Identifier
- 9984364405602771
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