{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T19:41:16Z","timestamp":1790106076816,"version":"4.0.1"},"reference-count":33,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2019,9,17]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>\n              Approximately 13% of black individuals carry 2 copies of the apolipoprotein L1 (\n              <jats:italic>APOL1<\/jats:italic>\n              ) risk alleles G1 or G2, which are associated with 1.5- to 2.5-fold increased risk of chronic kidney disease. There have been conflicting reports as to whether an association exists between\n              <jats:italic>APOL1<\/jats:italic>\n              risk alleles and cardiovascular disease (CVD) that is independent of the effects of\n              <jats:italic>APOL1<\/jats:italic>\n              on kidney disease. We sought to test the association of\n              <jats:italic>APOL1<\/jats:italic>\n              G1\/G2 alleles with coronary artery disease, peripheral artery disease, and stroke among black individuals in the Million Veteran Program.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>\n              We performed a time-to-event analysis of retrospective electronic health record data using Cox proportional hazard and competing-risks Fine and Gray subdistribution hazard models. The primary exposure was\n              <jats:italic>APOL1<\/jats:italic>\n              risk allele status. The primary outcome was incident coronary artery disease among individuals without chronic kidney disease during the 12.5-year follow-up period. We separately analyzed the cross-sectional association of\n              <jats:italic>APOL1<\/jats:italic>\n              risk allele status with lipid traits and 115 cardiovascular diseases using phenome-wide association.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>\n              Among 30\u2009903 black Million Veteran Program participants, 3941 (13%) carried the 2\n              <jats:italic>APOL1<\/jats:italic>\n              risk allele high-risk genotype. Individuals with normal kidney function at baseline with 2 risk alleles had slightly higher risk of developing coronary artery disease compared with those with no risk alleles (hazard ratio, 1.11 [95% CI, 1.01\u20131.21];\n              <jats:italic>P<\/jats:italic>\n              =0.039). Similarly, modest associations were identified with incident stroke (hazard ratio, 1.20 [95% CI, 1.05\u20131.36;\n              <jats:italic>P<\/jats:italic>\n              =0.007) and peripheral artery disease (hazard ratio, 1.15 [95% CI, 1.01\u20131.29l;\n              <jats:italic>P<\/jats:italic>\n              =0.031). When both cardiovascular and renal outcomes were modeled,\n              <jats:italic>APOL1<\/jats:italic>\n              was strongly associated with incident renal disease, whereas no significant association with the CVD end points could be detected. Cardiovascular phenome-wide association analyses did not identify additional significant associations with CVD subsets.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>\n              <jats:italic>APOL1<\/jats:italic>\n              risk variants display a modest association with CVD, and this association is likely mediated by the known\n              <jats:italic>APOL1<\/jats:italic>\n              association with chronic kidney disease.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circulationaha.118.036589","type":"journal-article","created":{"date-parts":[[2019,7,24]],"date-time":"2019-07-24T10:53:44Z","timestamp":1563965624000},"page":"1031-1040","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":52,"title":["Association of\n            <i>APOL1<\/i>\n            Risk Alleles With Cardiovascular Disease in Blacks in the Million Veteran Program"],"prefix":"10.1161","volume":"140","author":[{"given":"Alexander G.","family":"Bick","sequence":"first","affiliation":[{"name":"Boston VA Healthcare System, MA (A.G.B., J.E.H., J.H., L.H., D.K., K.C., J.M.G., C.J.O.)."},{"name":"Massachusetts General Hospital, Boston (A.G.B., D.K., P.N., S.K.)."},{"name":"Broad Institute of MIT and Harvard, Cambridge, MA (A.G.B., D.K., P.N., S.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elvis","family":"Akwo","sequence":"additional","affiliation":[{"name":"Nashville VA Medical Center, TN (E.A., C.R.-C., T.E., S.M.F., A.G., O.W., A.M.H.)."},{"name":"Vanderbilt University Medical Center, Nashville, TN (E.A., C.R.-C., T.E., S.M.F., A.G., A.M.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cassianne","family":"Robinson-Cohen","sequence":"additional","affiliation":[{"name":"Nashville VA Medical Center, TN (E.A., C.R.-C., T.E., S.M.F., A.G., O.W., A.M.H.)."},{"name":"Vanderbilt University Medical Center, Nashville, TN (E.A., C.R.-C., T.E., S.M.F., A.G., A.M.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyung","family":"Lee","sequence":"additional","affiliation":[{"name":"Edith Norse Rogers Memorial VA Medical Center, Bedford, MA (K.L., J.L., L.H., D.R.M., Q.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Lynch","sequence":"additional","affiliation":[{"name":"Edith Norse Rogers Memorial VA Medical Center, Bedford, MA (K.L., J.L., L.H., D.R.M., Q.S.)."},{"name":"University of Massachusetts College of Nursing &amp; Health Sciences, Boston (J.L.)."},{"name":"VA Informatics and Computing Infrastructure, Salt Lake City, UT (J.L., S.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Themistocles L.","family":"Assimes","sequence":"additional","affiliation":[{"name":"Palo Alto VA Health Care, CA (T.L.A., H.F., J.S.L., H.T., P.S.T.)."},{"name":"Stanford University School of Medicine, CA (T.L.A., H.F., J.S.L., H.T., P.S.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott","family":"DuVall","sequence":"additional","affiliation":[{"name":"VA Informatics and Computing Infrastructure, Salt Lake City, UT (J.L., S.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Todd","family":"Edwards","sequence":"additional","affiliation":[{"name":"Nashville VA Medical Center, TN (E.A., C.R.-C., T.E., S.M.F., A.G., O.W., A.M.H.)."},{"name":"Vanderbilt University Medical Center, Nashville, TN (E.A., C.R.-C., T.E., S.M.F., A.G., A.M.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huaying","family":"Fang","sequence":"additional","affiliation":[{"name":"Palo Alto VA Health Care, CA (T.L.A., H.F., J.S.L., H.T., P.S.T.)."},{"name":"Stanford University School of Medicine, CA (T.L.A., H.F., J.S.L., H.T., P.S.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. 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