Genome-Wide Association Study of Peripheral Artery Disease

Natalie R. Van Zuydam, Alexander Stiby, Moustafa Abdalla, Erin Austin, Emma H. Dahlström, Stela McLachlan, Efthymia Vlachopoulou, Emma Ahlqvist, Chen Di Liao, Niina Sandholm, Carol Forsblom, Anubha Mahajan, Neil R. Robertson, N. William Rayner, Eero Lindholm, Juha Sinisalo, Markus Perola, Milla Kallio, Emily Weiss, Jackie PriceAndrew Paterson, Barbara Klein, Veikko Salomaa, Colin N.A. Palmer, Per Henrik Groop, Leif Groop, Mark I. McCarthy, Mariza De Andrade, Andrew P. Morris, Jemma C. Hopewell, Helen M. Colhoun, Iftikhar J. Kullo

Research output: Contribution to journalArticlepeer-review


Background: Peripheral artery disease (PAD) affects >200 million people worldwide and is associated with high mortality and morbidity. We sought to identify genomic variants associated with PAD overall and in the contexts of diabetes and smoking status. Methods: We identified genetic variants associated with PAD and then meta-analyzed with published summary statistics from the Million Veterans Program and UK Biobank to replicate their findings. Next, we ran stratified genome-wide association analysis in ever smokers, never smokers, individuals with diabetes, and individuals with no history of diabetes and corresponding interaction analyses, to identify variants that modify the risk of PAD by diabetic or smoking status. Results: We identified 5 genome-wide significant (Passociation ≤5×10-8) associations with PAD in 449 548 (Ncases=12 086) individuals of European ancestry near LPA (lipoprotein [a]), CDKN2BAS1 (CDKN2B antisense RNA 1), SH2B3 (SH2B adaptor protein 3) - PTPN11 (protein tyrosine phosphatase non-receptor type 11), HDAC9 (histone deacetylase 9), and CHRNA3 (cholinergic receptor nicotinic alpha 3 subunit) loci (which overlapped previously reported associations). Meta-analysis with variants previously associated with PAD showed that 18 of 19 published variants remained genome-wide significant. In individuals with diabetes, rs116405693 at the CCSER1 (coiled-coil serine rich protein 1) locus was associated with PAD (odds ratio [95% CI], 1.51 [1.32-1.74], Pdiabetes=2.5×10-9, Pinteractionwithdiabetes=5.3×10-7). Furthermore, in smokers, rs12910984 at the CHRNA3 locus was associated with PAD (odds ratio [95% CI], 1.15 [1.11-1.19], Psmokers=9.3×10-10, Pinteractionwithsmoking=3.9×10-5). Conclusions: Our analyses confirm the published genetic associations with PAD and identify novel variants that may influence susceptibility to PAD in the context of diabetes or smoking status.

Original languageEnglish (US)
Pages (from-to)E002862
JournalCirculation: Genomic and Precision Medicine
Issue number5
StatePublished - Oct 1 2021


  • diabetes
  • genome-wide association study
  • peripheral vascular disease
  • smoking

ASJC Scopus subject areas

  • Genetics
  • Cardiology and Cardiovascular Medicine
  • Genetics(clinical)


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