), 13q12.11 as modifiers of SMYD2 LDLR , and IL6R DOI: 10.1161/CIRCRESAHA.116.308765 genome-wide association study genome-wide , In various database searches, we database searches, In various ■ Bown ). ERG IdentifiesFour ERG AAA risk loci: 1q32.3 ( genetics ■ meta-analysis ■ was 15.7 days. was . License, which permits use, distribution, and reproduction in any medium, in any and reproduction use, distribution, which permits License, ), and 21q22.2 ( 341 MMP9 and ZNF335 / computational biology computational Circulation Research Research Circulation ERG ■ Clinical Track MMP9 / 766 controls, we identified 4 new 766 controls, matrix metalloproteinases Disease-Specific Risk Loci ■ is published on behalf of the American Heart Association, Inc., by Wolters Kluwer Health, Inc. This is Kluwer Health, Inc. Wolters Association, Inc., by American Heart is published on behalf of the Creative Creative Attribution Commons PCIF1 Andre M. van Rij, Nilesh J. Samani, Matthew J. Rij, Nilesh J. Samani, Matthew Andre M. van New Through a meta-analysis of 6 genome-wide association study data sets and a validation of 6 genome-wide association study data sets and a validation a meta-analysis Through 204 cases and 107 Abdominal Aortic Aneurysm Circulation Research Circulation is available at http://circres.ahajournals.org is available aortic aneurysm, abdominal aortic The 4 new risk loci for AAA seem to be specific for AAA compared with other cardiovascular with other cardiovascular AAA compared for AAA seem to be specific The 4 new risk loci for ), 20q13.12 (near for Abdominal aortic aneurysm (AAA) is a complex disease with both genetic and environmental risk environmental genetic and both disease with a complex (AAA) is aortic aneurysm Abdominal . 2017;120:341-353. DOI: 10.1161/CIRCRESAHA.116.308765.) To identify additional AAA risk loci using data from all available genome-wide association studies. all available AAA risk loci using data from identify additional To John R. Thompson, Paul I.W. de Bakker, Panos Deloukas, Robert D. Sayers, Seamus C. Harrison, Panos de Bakker, I.W. Thompson, Paul John R. Johan L.M. Björkegren, Leonard Lipovich, Anne M. Drolet, Eric L. Verhoeven, Clark J. Zeebregts, Clark J. Zeebregts, Verhoeven, Anne M. Drolet, Eric L. Leonard Lipovich, Johan L.M. Björkegren, , with a direct interaction between , with a direct Meta-Analysis of Genome-Wide Association Studies Meta-Analysis of Genome-Wide Unnur Thorsteinsdottir, Jan D. Blankensteijn, Joep A.W. Teijink, Cisca Wijmenga, Jacqueline de Graaf, Wijmenga, Cisca Teijink, A.W. Joep Jan D. Blankensteijn, Thorsteinsdottir, Unnur John D. Eicher, Andrew D. Johnson, Christer Betsholtz, Arno Ruusalepp, Oscar Franzén, Eric E. Schadt, D. Johnson, Christer Betsholtz, Andrew John D. Eicher, Laura J. Rasmussen-Torvik, Kenneth M. Borthwick, Diane T. Smelser, David R. Crosslin, Mariza de Andrade, R. Crosslin, Mariza de David Smelser, T. M. Borthwick, Diane Kenneth Laura J. Rasmussen-Torvik, Glenn S. Gerhard, David P. Franklin, David J. Carey, Victoria L. Phillips, Michael J.A. Williams, Wenhua Wei, Wei, Wenhua Williams, L. Phillips, Michael J.A. Victoria J. Carey, Franklin, David P. Glenn S. Gerhard, David Ana R. Verissimo, Suzannah Bumpstead, Stephen A. Badger, Rachel E. Clough, Gillian Cockerill, Hany Hafez, Hany Rachel E. Clough, Gillian Cockerill, A. Badger, Suzannah Bumpstead, Stephen Verissimo, Ana R. Natzi Sakalihasan, Audrey Courtois, Robert E. Ferrell, Per Eriksson, Lasse Folkersen, Anders Franco-Cereceda, Courtois, Robert E. Ferrell, Per Eriksson, Lasse Folkersen, Audrey Natzi Sakalihasan, Robert H. Geelkerken, Marc R. van Sambeek, Steven M. van Sterkenburg, Jean-Paul de Vries, Kari Stefansson, Vries, Kari Stefansson, de Jean-Paul Sterkenburg, M. van Sambeek, Steven Marc R. van Robert H. Geelkerken, LINC00540 Circ Res Alberto Smith, Matthew M. Thompson, Frank M. van Bockxmeer, Stefan E. Matthiasson, Gudmar Thorleifsson, E. Matthiasson, Gudmar Stefan Bockxmeer, Thompson, Frank M. van M. Alberto Smith, Matthew D. Julian A. Scott, T. Simon Futers, Simon P.R. Romaine, Katherine Bridge, Kathryn J. Griffin, Marc A. Bailey, A. Bailey, Romaine, Katherine Bridge, Kathryn J. Griffin, Marc Simon Futers, Simon P.R. T. A. Scott, D. Julian Key Words: Key Femke N.G. van‘t Hof, Thomas R. Webb, Robert Erdman, Marylyn D. Ritchie, James R. Elmore, Anurag Verma, Verma, Anurag Robert Erdman, Marylyn D. Ritchie, James R. Elmore, Webb, Thomas R. Hof, N.G. van‘t Femke ( observed no new associations between the lead AAA single nucleotide polymorphisms and coronary artery disease, and coronary nucleotide polymorphisms AAA single the lead new associations between no observed analyses identified lipids, or diabetes mellitus. Network blood pressure, MMP9 diseases and related traits suggesting that traditional cardiovascular risk factor management may only have risk factor management may only have traits suggesting that traditional cardiovascular diseases and related of aneurysmal disease. the progression in preventing limited value ( study totaling 10 factors. Together, 6 previously identified risk loci only explain a small proportion of the heritability of AAA. of the heritability of identified risk loci only explain a small proportion 6 previously Together, factors. Lambertus A. Kiemeney, Jes S. Lindholt, Anne Hughes, Declan T. Bradley, Kathleen Stirrups, Jonathan Golledge, Bradley, T. Anne Hughes, Declan Jes S. Lindholt, A. Kiemeney, Lambertus Ross Blair, Andrew A. Hill, Thodor M. Vasudevan, David R. Lewis, Ian A. Thomson, Jo Krysa, Geraldine B. Hill, A. Ian R. Lewis, David Vasudevan, Thodor M. A. Hill, Andrew Ross Blair, Evan J. Ryer, Catherine A. McCarty, Erwin P. Böttinger, Jennifer A. Pacheco, Dana C. Crawford, David S. Carrell, David Dana C. Crawford, A. Pacheco, Jennifer Böttinger, Erwin P. A. McCarty, Catherine J. Ryer, Evan Circulation Research © 2016 The Authors. Original received March 23, 2016; revision received October 28, 2016; accepted November 21, 2016. In October 2016, the average time from submission time from the average October 2016, 21, 2016. In accepted November 28, 2016; October received 2016; revision March 23, Original received Appendix. the author affiliations, please see the For with this article at http://circres.ahajournals.org/lookup/suppl/doi:10.1161/CIRCRESAHA. The online-only Data Supplement is available LE2 7LX, of Leicester Robert Kilpatrick Bldg, Leicester, Sciences, University MBBCh, MD, Cardiovascular J. Bown, Correspondence to Matthew Carlo Pratesi, The Cardiogenics Consortium, The International Consortium for Blood Pressure, Athanasios Saratzis, The International Consortium for Blood Pressure, The Cardiogenics Consortium, Carlo Pratesi, Paul E. Norman, Janet T. Powell, Steve E. Humphries, Stephen E. Hamby, Alison H. Goodall, Christopher P. Nelson, Alison H. Goodall, Christopher P. E. Humphries, Stephen E. Hamby, Steve Powell, T. E. Norman, Janet Paul Justin Roake, Tony R. Merriman, Grzegorz Oszkinis, Silvia Galora, Claudia Saracini, Rosanna Abbate, Raffaele Pulli, Abbate, Raffaele Oszkinis, Silvia Galora, Claudia Saracini, Rosanna R. Merriman, Grzegorz Tony Justin Roake, Sarah Pendergrass, Iftikhar J. Kullo, Zi Ye, Peggy L. Peissig, Omri Gottesman, Shefali S. Verma, Jennifer Malinowski, Jennifer Malinowski, Verma, S. L. Peissig, Omri Gottesman, Shefali Peggy Ye, Zi Iftikhar J. Kullo, Sarah Pendergrass, Gregory T. Jones, Gerard Tromp, Helena Kuivaniemi, Solveig Gretarsdottir, Annette F. Baas, Betti Giusti, Ewa Strauss, Baas, Betti Giusti, Ewa Annette F. Gretarsdottir, Solveig Helena Kuivaniemi, Tromp, Jones, Gerard T. Gregory provided that the original work is properly cited. that the original work provided an open access article under the terms of the terms of under the access article an open to first decision for all original research papers submitted to 116.308765/-/DC1. Zealand. E-mail of Otago, Dunedin 9054, New Department, University Jones, PhD, Surgery T. or Gregory United Kingdom. E-mail [email protected]; [email protected] Conclusions: Methods and Results: Rationale: Objective: Downloaded from http://circres.ahajournals.org/ by guest on March 23, 2017 342 Circulation Research January 20, 2017 Novelty and Significance What Is Known? identified risk loci explain only a small proportion of this effect. No current effective medical therapies that slow AAA growth • Abdominal aortic aneurysm (AAA) has a prevalence of ≈1.5% in men aged >65 years. exist, highlighting the need to better understand factors influ- • Positive family history of AAA is a strong risk factor for AAA; however, encing pathogenesis and disease progression. This study is only 6 robust and independently validated AAA genetic loci have been the first meta-analysis of genome-wide association studies for identified to date. AAA (10 204 cases). Four novel loci were identified and 5 of the 6 previous AAA genetic associations were confirmed. The new What New Information Does This Article Contribute? loci showed no significant associations with other arterial disease phenotypes, potentially suggesting associations more specific to • Four novel genetic loci associated with AAA were identified. • Pathway analysis highlighted the potential importance of lipoprotein AAA than known loci (such as CDKN2BAS1, SORT1, and LDLR). metabolism, inflammation, and matrix metalloproteinases in AAA Associations were consistent with known AAA pathobiology, im- pathobiology. plicating lipoprotein metabolism, inflammation, and matrix me- • Potentially novel mechanisms, involving genes such as ERG, PLTP, and talloproteinases