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Stroke genetics informs drug discovery and risk prediction across ancestries

  • The COMPASS Consortium
  • , The INVENT Consortium
  • , The Dutch Parelsnoer Initiative (PSI) Cerebrovascular Disease Study Group
  • , The Estonian Biobank
  • , The PRECISEQ Consortium
  • , The FinnGen Consortium
  • , The NINDS Stroke Genetics Network (SiGN)
  • , The MEGASTROKE Consortium
  • , The SIREN Consortium
  • , The China Kadoorie Biobank Collaborative Group
  • , The VA Million Veteran Program
  • , The International Stroke Genetics Consortium (ISGC)
  • , The Biobank Japan
  • , The CHARGE Consortium
  • , The GIGASTROKE Consortium
  • , Regeneron Genetics Center
  • , The ODYSSEY Study
  • , HUNT All-In Stroke
  • , The SICFAIL Study
  • , The Generacion Study
  • The Copenhagen City Heart Study, The SMART Study, Clinical Research Collaboration for Stroke in Korea (CRCS-K) and Korea Biobank Array (KBA) Project, Helsinki Stroke Project, Follow-up Studies, EPIC-CVD
  • Bordeaux Population Health Research Center (BPH)
  • Ludwig-Maximilians-University
  • Iwate Medical University
  • University of Tartu
  • University of Tartu
  • Osaka University Graduate School of Medicine
  • VA Boston Healthcare System
  • Brigham and Women's Hospital
  • Harvard Medical School
  • University of Tokyo
  • Massachusetts General Hospital
  • Broad Institute
  • Chung- Shan Medical University
  • University of Turku
  • Finnish Institute for Health and Welfare - THL
  • University of Oxford Medical Sciences Division
  • Oslo University Hospital
  • Norwegian University of Science and Technology (NTNU)
  • University of Alabama at Birmingham School of Public Health
  • Seoul National University Bundang Hospital
  • Rajendra Institute of Medical Sciences
  • McMaster University
  • Michael G. DeGroote School of Medicine
  • Helsinki University Central Hospital
  • Department of Medicine
  • Erasmus MC
  • Hebrew University of Jerusalem
  • Harvard School of Public Health
  • University Hospital of Copenhagen - Rigshospitalet
  • Weis Center for Research
  • Pennsylvania State University
  • Institut d’Investigació Biomèdica Sant Pau
  • Autonomous University of Barcelona (UAB)
  • University of Southern Denmark
  • Odense University Hospital
  • National Institutes of Health (NIH)
  • National Institute on Aging (NIA)
  • Data Tecnica International
  • University of Virginia School of Medicine
  • Department of Public Health and Primary Care
  • University of Oxford
  • Vanderbilt University Medical Center
  • University of Pennsylvania
  • Graduate School of Medical Sciences
  • University of Lille
  • Lille Regional University Hospital Centre
  • Pasteur Institute of Lille
  • University of Alabama at Birmingham
  • University Medical Centre Utrecht
  • University of Washington School of Medicine
  • University of Washington
  • Rush University Medical Center
  • University of Oslo
  • Clinical Trial Service Unit and Epidemiological Studies Unit
  • Washington University School of Medicine in St. Louis
  • James J. Peters VA Medical Center
  • University of Maryland School of Medicine
  • Columbia University Medical Center
  • Germans Trias i Pujol Research Institute (IGTP)
  • Charité – Universitätsmedizin Berlin
  • Center for Stroke Research Berlin
  • German Center for Neurodegenerative Diseases (DZNE)
  • Partner site Berlin
  • University of the Region of Joinville
  • Icelandic Heart Association
  • University of Iceland
  • Imperial College London
  • University of Helsinki
  • University of Cincinnati College of Medicine
  • Molecular Cardiology Laboratory
  • University of Cambridge
  • Donders Institute for Brain, Cognition and Behaviour
  • Los Angeles County Department of Public Health
  • Gothenburg University
  • Sahlgrenska University Hospital
  • Brody School of Medicine
  • Monash University
  • Korea University Guro Hospital
  • University of Lausanne
  • Swiss Institute of Bioinformatics
  • University Center for Primary Care and Public Health
  • Peking University Health Science Center
  • University of Cambridge
  • Technical University Munich
  • German Research Center for Environmental Health
  • Baltimore VA Medical Center
  • University of Wuerzburg
  • University of Würzburg
  • University of Mississippi Medical Center
  • Gentofte University Hospital
  • University of Copenhagen
  • Graduate School of Medicine
  • RIKEN Center for Integrative Medical Sciences
  • Osaka University
  • Osaka University
  • University of California San Francisco
  • Ludwig-Maximilians-University Munich
  • University of Miami Leonard M. Miller School of Medicine
  • University of Florida
  • Columbia University
  • The Norwegian Air Ambulance Foundation
  • University of Texas Health Science Center at San Antonio
  • Framingham Heart Study
  • University Medicine Greifswald
  • Southern California Permanente Medical Group
  • Us Department of Veterans Affairs (VA)
  • Atlanta VA Health Care System
  • Rollins School of Public Health
  • Leiden University Medical Center
  • University of Tartu
  • Umeå University
  • Emory University School of Medicine
  • Boston University School of Public Health
  • National Institute of Health
  • Interuniv. Cardiol. Inst. N.
  • Universidad Adolfo Ibanez
  • Albert Einstein College of Medicine
  • University of Virginia
  • McGill University
  • Geisinger Health System
  • Helmholtz Institute for Functional Marine Biodiversity at the University Oldenburg (HIFMB)
  • Yonsei University
  • McMaster University
  • Population Health Research Institute, Ontario
  • Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center
  • Turku University Hospital
  • University of Texas
  • University of Texas
  • Chung Shan Medical University Hospital
  • Boston University School of Medicine
  • Munich Cluster for Systems Neurology (SyNergy)
  • Bordeaux University Hospital
  • Mayo Clinic in Jacksonville, Florida
  • Barts and The London School of Medicine and Dentistry
  • King's College London
  • Washington State University Spokane
  • Fred Hutchinson Cancer Center
  • Wake Forest University School of Medicine
  • The Johns Hopkins University School of Medicine
  • Synaptic Function Section
  • University of California San Francisco
  • University of Colorado Denver
  • Alpert Medical School of Brown University
  • College of Public Health
  • University of British Columbia
  • Saint Francis Medical Center
  • Trondheim University Hospital
  • University of California San Diego
  • University of Tromsø - The Arctic University of Norway
  • Mayo Clinic
  • School of Public Health
  • MRC Integrative Epidemiology Unit
  • La Timone University Hospital
  • Aix-Marseille Université
  • University Hospital of North Norway
  • University of Minnesota Medical School
  • Ohio State University
  • Ohio State University Wexner Medical Center
  • University of Michigan Medical School
  • Statens Serum Institut
  • Department of Pediatrics
  • Université Paris-Sud
  • CEPH-Fondation Jean Dausset
  • Veteran’s Administration
  • Assistance Publique Hôpitaux de Marseille
  • University Medical Center Groningen
  • University of Amsterdam
  • Maastricht University
  • John Hunter Hospital
  • University of Technology Sydney
  • Royal Holloway, University of London
  • Ashford and St Peter Hospitals NHS Trust
  • University of Edinburgh
  • Medical University of Graz
  • Uniwersytet Jagielloński
  • University of Melbourne
  • Austin Health
  • Lund University
  • Skane University Hospital
  • Lund University
  • UF Health Heart and Vascular Hospital
  • University of Florida College of Medicine
  • Wellcome Trust Genome Campus
  • Department of Medicine
  • Fondazione IRCCS-Istituto Neurologico Carlo Besta
  • University of Brescia
  • University Medicine Rostock
  • University of Michigan, Ann Arbor
  • University of Leuven
  • KU Leuven– University Hospital Leuven
  • University of Vermont Larner College of Medicine
  • Chang Gung Memorial Hospital
  • University of Pittsburgh School of Medicine
  • Hospital Universitari Mútua de Terrassa
  • Beth Israel Deaconess Medical Center
  • Hospital Universitario Virgen del Rocío
  • University of Glasgow
  • deCODE genetics
  • University of Lincoln
  • Stroke Pharmacogenomics and Genetics
  • Science for Life Laboratory
  • University of North Carolina
  • University Hospital Basel
  • University of Basel
  • Yale University School of Medicine
  • Uppsala University
  • Leeds General Infirmary
  • Hunter Medical Research Institute, Australia
  • University of Newcastle, College of Health, Medicine and Wellbeing
  • Stanford University School of Medicine
  • MRC Epidemiology Unit
  • Charité Universitätsmedizin Berlin
  • Queen Mary University of London
  • Université Lille
  • MRC Biostatistics Unit
  • University of Gothenburg
  • Karolinska Institutet
  • University of Oklahoma College of Medicine
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  • University of Glasgow
  • University Montpellier 1
  • Barcelona Institute for Global Health
  • University of Perugia
  • University of Glasgow
  • DMCH
  • Tohoku University
  • University Health Network
  • University of Toronto
  • National Cancer Center Japan
  • Landspitali - The National University Hospital of Iceland
  • Ruprecht-Karls-University Heidelberg
  • Montefiore Medical Center
  • Wellcome Trust Centre for Human Genetics
  • University of Liverpool
  • Department of Neuroscience
  • University of Barcelona
  • Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM)
  • Guys and St Thomas' NHS Foundation Trust
  • Aichi Cancer Center Research Institute
  • Nagoya University Graduate School of Medicine
  • CHU Caen
  • Université de Caen-Normandie
  • University of Oklahoma Health Sciences Center
  • Oklahoma Center for Neuroscience
  • IMIM-Hospital del Mar
  • University of Ibadan
  • Kwame Nkrumah University of Science and Technology
  • University of Ghana
  • Ahmadu Bello University
  • University of Ilorin
  • University of Jos
  • Aminu Kano Teaching Hospital
  • Obafemi Awolowo University
  • Medical University of South Carolina
  • China National Center for Food Safety Risk Assessment
  • Chinese Academy of Medical Sciences
  • Institute of Basic Medical Sciences
  • Baylor College of Medicine
  • Haga Hospital
  • Amphia Ziekenhuis
  • Elisabeth-TweeSteden Ziekenhuis
  • Rijnstate Hospital
  • Medisch Spectrum Twente (MST)
  • Catharina Hospital
  • Franciscus Gasthuis & amp; Vlietland
  • Catharina Wilhelmina Hospital
  • Medisch Centrum Leeuwarden
  • University of Michigan School of Public Health
  • University of Oslo
  • Akershus University Hospital
  • University Clinics
  • Hospital de la Santa Creu I
  • Hospital Clinic de Barcelona-IDIBAPS and CIBEREHD
  • Health Research Institute of Santiago de Compostela (IDIS)
  • Cruces University Hospital
  • Hospital Clínico Universitario de Valladolid
  • Hospital Clínic
  • Hospital Universitari Vall d'Hebron
  • Hospital Universitario Central de Asturias
  • Hospital Son Dureta
  • Complejo Hospitalario Universitario de Albacete
  • Copenhagen University Hospital
  • Columbia University

Research output: Contribution to a Journal (Peer & Non Peer)Articlepeer-review

452 Citations (Scopus)

Abstract

Previous genome-wide association studies (GWASs) of stroke — the second leading cause of death worldwide — were conducted predominantly in populations of European ancestry1,2. Here, in cross-ancestry GWAS meta-analyses of 110,182 patients who have had a stroke (five ancestries, 33% non-European) and 1,503,898 control individuals, we identify association signals for stroke and its subtypes at 89 (61 new) independent loci: 60 in primary inverse-variance-weighted analyses and 29 in secondary meta-regression and multitrait analyses. On the basis of internal cross-ancestry validation and an independent follow-up in 89,084 additional cases of stroke (30% non-European) and 1,013,843 control individuals, 87% of the primary stroke risk loci and 60% of the secondary stroke risk loci were replicated (P < 0.05). Effect sizes were highly correlated across ancestries. Cross-ancestry fine-mapping, in silico mutagenesis analysis3, and transcriptome-wide and proteome-wide association analyses revealed putative causal genes (such as SH3PXD2A and FURIN) and variants (such as at GRK5 and NOS3). Using a three-pronged approach4, we provide genetic evidence for putative drug effects, highlighting F11, KLKB1, PROC, GP1BA, LAMC2 and VCAM1 as possible targets, with drugs already under investigation for stroke for F11 and PROC. A polygenic score integrating cross-ancestry and ancestry-specific stroke GWASs with vascular-risk factor GWASs (integrative polygenic scores) strongly predicted ischaemic stroke in populations of European, East Asian and African ancestry5. Stroke genetic risk scores were predictive of ischaemic stroke independent of clinical risk factors in 52,600 clinical-trial participants with cardiometabolic disease. Our results provide insights to inform biology, reveal potential drug targets and derive genetic risk prediction tools across ancestries.

Original languageEnglish
Pages (from-to)115-123
Number of pages9
JournalNature
Volume611
Issue number7934
DOIs
Publication statusPublished - 3 Nov 2022

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

  1. SDG 3 - Good Health and Well-being
    SDG 3 Good Health and Well-being

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