Impact of genetic background as a risk factor for atherosclerotic cardiovascular disease: A protocol for a nationwide genetic case-control (CV-GENES) study in Brazil

PLoS One. 2024 Mar 13;19(3):e0289439. doi: 10.1371/journal.pone.0289439. eCollection 2024.

Abstract

Atherosclerotic Cardiovascular Disease (ASCVD) represents the leading cause of death worldwide, and individual screening should be based on behavioral, metabolic, and genetic profile derived from data collected in large population-based studies. Due to the polygenic nature of ASCVD, we aimed to assess the association of genomics with ASCVD risk and its impact on the occurrence of acute myocardial infarction, stroke, or peripheral artery thrombotic-ischemic events at population level. CardioVascular Genes (CV-GENES) is a nationwide, multicenter, 1:1 case-control study of 3,734 patients in Brazil. Inclusion criterion for cases is the first occurrence of one of the ASCVD events. Individuals without known ASCVD will be eligible as controls. A core lab will perform the genetic analyses through low-pass whole genome sequencing and whole exome sequencing. In order to estimate the independent association between genetic polymorphisms and ASCVD, a polygenic risk score (PRS) will be built through a hybrid approach including effect size of each Single Nucleotide Polymorphism (SNP), number of effect alleles observed, sample ploidy, total number of SNPs included in the PRS, and number of non-missing SNPs in the sample. In addition, the presence of pathogenic or likely pathogenic variants will be screened in 8 genes (ABCG5, ABCG8, APOB, APOE, LDLR, LDLRAP1, LIPA, PCSK9) associated with atherosclerosis. Multiple logistic regression will be applied to estimate adjusted odds ratios (OR) and 95% confidence intervals (CI), and population attributable risks will be calculated. Clinical trial registration: This study is registered in clinicaltrials.gov (NCT05515653).

MeSH terms

  • Atherosclerosis* / epidemiology
  • Atherosclerosis* / genetics
  • Brazil / epidemiology
  • Cardiovascular Diseases* / epidemiology
  • Cardiovascular Diseases* / genetics
  • Cardiovascular Diseases* / prevention & control
  • Case-Control Studies
  • Genetic Background
  • Humans
  • Multicenter Studies as Topic
  • Proprotein Convertase 9
  • Risk Factors

Substances

  • PCSK9 protein, human
  • Proprotein Convertase 9

Associated data

  • ClinicalTrials.gov/NCT05515653

Grants and funding

This study is funded by the Brazilian Ministry of Health, through Adjustment Term 04/2020 – PROADI-SUS. The funder has no role in study design; collection, management, analysis, and interpretation of data; or writing of the report. The national coordination has the final decision to submit any report for publication.