Contribution of Common Genetic Variants to Risk of Early-Onset Ischemic Stroke
Jaworek T., Xu H., Gaynor BJ., Cole JW., Rannikmae K., Stanne TM., Tomppo L., Abedi V., Amouyel P., Armstrong ND., Attia J., Bell S., Benavente OR., Boncoraglio GB., Butterworth A., Carcel-Marquez J., Chen Z., Chong M., Cruchaga C., Cushman M., Danesh J., Debette S., Duggan DJ., Durda JP., Engstrom G., Enzinger C., Faul JD., Fecteau NS., Fernandez-Cadenas I., Gieger C., Giese AK., Grewal RP., Grittner U., Havulinna AS., Heitsch L., Hochberg MC., Holliday E., Hu J., Ilinca A., Irvin MR., Jackson RD., Jacob MA., Rabionet R., Jimenez-Conde J., Johnson JA., Kamatani Y., Kardia SLR., Koido M., Kubo M., Lange L., Lee JM., Lemmens R., Levi CR., Li J., Li L., Lin K., Lopez H., Luke S., Maguire J., McArdle PF., McDonough CW., Meschia JF., Metso T., Müller-Nurasyid M., O'Connor TD., O'Donnell M., Peddareddygari LR., Pera J., Perry JA., Peters A., Putaala J., Ray D., Rexrode K., Ribases M., Rosand J., Rothwell PM., Rundek T., Ryan KA., Sacco RL., Salomaa V., Sanchez-Mora C., Schmidt R., Sharma P., Slowik A., Smith JA., Smith NL., Wassertheil-Smoller S., Söderholm M., Stine OC., Strbian D., Sudlow CLM., Tatlisumak T., Terao C., Thijs V., Torres-Aguila NP., Trégouët DA., Tuladhar AM., Veldink JH., Walters RG., Weir DR.
Background and ObjectivesCurrent genome-wide association studies of ischemic stroke have focused primarily on late-onset disease. As a complement to these studies, we sought to identify the contribution of common genetic variants to risk of early-onset ischemic stroke.MethodsWe performed a meta-analysis of genome-wide association studies of early-onset stroke (EOS), ages 18-59 years, using individual-level data or summary statistics in 16,730 cases and 599,237 nonstroke controls obtained across 48 different studies. We further compared effect sizes at associated loci between EOS and late-onset stroke (LOS) and compared polygenic risk scores (PRS) for venous thromboembolism (VTE) between EOS and LOS.ResultsWe observed genome-wide significant associations of EOS with 2 variants in ABO, a known stroke locus. These variants tag blood subgroups O1 and A1, and the effect sizes of both variants were significantly larger in EOS compared with LOS. The odds ratio (OR) for rs529565, tagging O1, was 0.88 (95% confidence interval [CI]: 0.85-0.91) in EOS vs 0.96 (95% CI: 0.92-1.00) in LOS, and the OR for rs635634, tagging A1, was 1.16 (1.11-1.21) for EOS vs 1.05 (0.99-1.11) in LOS; p-values for interaction = 0.001 and 0.005, respectively. Using PRSs, we observed that greater genetic risk for VTE, another prothrombotic condition, was more strongly associated with EOS compared with LOS (p = 0.008).DiscussionThe ABO locus, genetically predicted blood group A, and higher genetic propensity for venous thrombosis are more strongly associated with EOS than with LOS, supporting a stronger role of prothrombotic factors in EOS.