{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T19:35:04Z","timestamp":1790710504716,"version":"4.1.0"},"reference-count":54,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"17","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2020,10,27]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>Abdominal aortic aneurysm (AAA) is an important cause of cardiovascular mortality; however, its genetic determinants remain incompletely defined. In total, 10 previously identified risk loci explain a small fraction of AAA heritability.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>We performed a genome-wide association study in the Million Veteran Program testing \u224818 million DNA sequence variants with AAA (7642 cases and 172\u2009172 controls) in veterans of European ancestry with independent replication in up to 4972 cases and 99\u2009858 controls. We then used mendelian randomization to examine the causal effects of blood pressure on AAA. We examined the association of AAA risk variants with aneurysms in the lower extremity, cerebral, and iliac arterial beds, and derived a genome-wide polygenic risk score (PRS) to identify a subset of the population at greater risk for disease.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>\n              Through a genome-wide association study, we identified 14 novel loci, bringing the total number of known significant AAA loci to 24. In our mendelian randomization analysis, we demonstrate that a genetic increase of 10 mm\u2009Hg in diastolic blood pressure (odds ratio, 1.43 [95% CI, 1.24\u20131.66];\n              <jats:italic>P<\/jats:italic>\n              =1.6\u00d710\n              <jats:sup>\u22126<\/jats:sup>\n              ), as opposed to systolic blood pressure (odds ratio, 1.06 [95% CI, 0.97\u20131.15];\n              <jats:italic>P<\/jats:italic>\n              =0.2), likely has a causal relationship with AAA development. We observed that 19 of 24 AAA risk variants associate with aneurysms in at least 1 other vascular territory. A 29-variant PRS was strongly associated with AAA (odds ratio\n              <jats:sub>PRS<\/jats:sub>\n              , 1.26 [95% CI, 1.18\u20131.36];\n              <jats:italic>P<\/jats:italic>\n              <jats:sub>PRS<\/jats:sub>\n              =2.7\u00d710\n              <jats:sup>\u221211<\/jats:sup>\n              per SD increase in PRS), independent of family history and smoking risk factors (odds ratio\n              <jats:sub>PRS+family history+smoking<\/jats:sub>\n              , 1.24 [95% CI, 1.14\u20131.35];\n              <jats:italic>P<\/jats:italic>\n              <jats:sub>PRS<\/jats:sub>\n              =1.27\u00d710\n              <jats:sup>\u22126<\/jats:sup>\n              ). Using this PRS, we identified a subset of the population with AAA prevalence greater than that observed in screening trials informing current guidelines.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>We identify novel AAA genetic associations with therapeutic implications and identify a subset of the population at significantly increased genetic risk of AAA independent of family history. Our data suggest that extending current screening guidelines to include testing to identify those with high polygenic AAA risk, once the cost of genotyping becomes comparable with that of screening ultrasound, would significantly increase the yield of current screening at reasonable cost.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circulationaha.120.047544","type":"journal-article","created":{"date-parts":[[2020,9,28]],"date-time":"2020-09-28T09:01:14Z","timestamp":1601283674000},"page":"1633-1646","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":147,"title":["Genetic Architecture of Abdominal Aortic Aneurysm in the Million Veteran Program"],"prefix":"10.1161","volume":"142","author":[{"given":"Derek","family":"Klarin","sequence":"first","affiliation":[{"name":"Malcolm Randall VA Medical Center, Gainesville, FL (D.K., S.T.S., S.A.B.)."},{"name":"Division of Vascular Surgery and Endovascular Therapy, University of Florida College of Medicine, Gainesville (D.K., S.T.S., S.A.B.)."},{"name":"Center for Genomic Medicine (D.K., W.Z., P.N.), Massachusetts General Hospital, Harvard Medical School, Boston."},{"name":"Program in Medical and Population Genetics (D.K.), Broad Institute of MIT and Harvard, Cambridge, MA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shefali Setia","family":"Verma","sequence":"additional","affiliation":[{"name":"Department of Genetics (S.S.V., M.R.), Perelman School of Medicine, University of Pennsylvania, Philadelphia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renae","family":"Judy","sequence":"additional","affiliation":[{"name":"Department of Surgery (R.J., S.M.D.), Perelman School of Medicine, University of Pennsylvania, Philadelphia."},{"name":"Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA (R.J., M.G.L., K.-M.C., S.M.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9906-8608","authenticated-orcid":true,"given":"Ozan","family":"Dikilitas","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN (O.D., I.J.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3153-1552","authenticated-orcid":true,"given":"Brooke N.","family":"Wolford","sequence":"additional","affiliation":[{"name":"Department of Computational Medicine and Bioinformatics (B.N.W., C.W.), University of Michigan Medical School, Ann Arbor."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ishan","family":"Paranjpe","sequence":"additional","affiliation":[{"name":"Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY (I.P., G.N.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9937-9932","authenticated-orcid":true,"given":"Michael G.","family":"Levin","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine (M.G.L.), Perelman School of Medicine, University of Pennsylvania, Philadelphia."},{"name":"Department of Medicine (M.G.L., D.J.R., K.-M.C.), Perelman School of Medicine, University of Pennsylvania, Philadelphia."},{"name":"Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA (R.J., M.G.L., K.-M.C., S.M.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8152-2489","authenticated-orcid":true,"given":"Cuiping","family":"Pan","sequence":"additional","affiliation":[{"name":"Palo Alto Epidemiology Research and Information Center for Genomics (C.P.), CA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9559-4339","authenticated-orcid":true,"given":"Catherine","family":"Tcheandjieu","sequence":"additional","affiliation":[{"name":"VA Palo Alto Health Care System (C.T., J.M.S., T.L.A., P.S.T.), CA."},{"name":"Division of Cardiovascular Medicine, Department of Medicine (C.T., J.M.S., T.L.A., P.S.T.), Stanford University School of Medicine, CA."},{"name":"Department of Pediatric Cardiology (C.T.), Stanford University School of Medicine, CA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua M.","family":"Spin","sequence":"additional","affiliation":[{"name":"VA Palo Alto Health Care System (C.T., J.M.S., T.L.A., P.S.T.), CA."},{"name":"Division of Cardiovascular Medicine, Department of Medicine (C.T., J.M.S., T.L.A., P.S.T.), Stanford University School of Medicine, CA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Lynch","sequence":"additional","affiliation":[{"name":"Edith Nourse VA Medical Center, Bedford, MA (J.L.)."},{"name":"VA Informatics and Computing Infrastructure, VA Salt Lake City Health Care System, UT (J.L., S.L.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2349-0009","authenticated-orcid":true,"given":"Themistocles L.","family":"Assimes","sequence":"additional","affiliation":[{"name":"VA Palo Alto Health Care System (C.T., J.M.S., T.L.A., P.S.T.), CA."},{"name":"Division of Cardiovascular Medicine, Department of Medicine (C.T., J.M.S., T.L.A., P.S.T.), Stanford University School of Medicine, CA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linn","family":"\u00c5ldstedt Nyr\u00f8nning","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, St. Olavs Hospital, Trondheim, Norway (L.\u00c5.N., E.M.)."},{"name":"Department of Circulation and Medical Imaging (L.\u00c5.N., E.M.), Norwegian University of Science and Technology, Trondheim, Norway."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erney","family":"Mattsson","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, St. Olavs Hospital, Trondheim, Norway (L.\u00c5.N., E.M.)."},{"name":"Department of Circulation and Medical Imaging (L.\u00c5.N., E.M.), Norwegian University of Science and Technology, Trondheim, Norway."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Todd L.","family":"Edwards","sequence":"additional","affiliation":[{"name":"Division of Epidemiology, Department of Medicine, Vanderbilt-Ingram Cancer Center (T.L.E.), Vanderbilt University Medical Center, Nashville, TN."},{"name":"Vanderbilt Genetics Institute (T.L.E., J.D.), Vanderbilt University Medical Center, Nashville, TN."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josh","family":"Denny","sequence":"additional","affiliation":[{"name":"Vanderbilt Genetics Institute (T.L.E., J.D.), Vanderbilt University Medical Center, Nashville, TN."},{"name":"Department of Biomedical Informatics (J.D., E.L., D.C.), Vanderbilt University Medical Center, Nashville, TN."},{"name":"Kaiser Permanente Washington Health Research Institute, Seattle (J.D., E.L., D.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Larson","sequence":"additional","affiliation":[{"name":"Department of Biomedical Informatics (J.D., E.L., D.C.), Vanderbilt University Medical Center, Nashville, TN."},{"name":"Kaiser Permanente Washington Health Research Institute, Seattle (J.D., E.L., D.C.)."},{"name":"Departments of Medicine and Health Services (E.L.), University of Washington, Seattle."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming Ta Michael","family":"Lee","sequence":"additional","affiliation":[{"name":"Genomic Medicine Institute, Geisinger Health System, Danville, PA (M.T.M.L., Y.Z.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Carrell","sequence":"additional","affiliation":[{"name":"Department of Biomedical Informatics (J.D., E.L., D.C.), Vanderbilt University Medical Center, Nashville, TN."},{"name":"Kaiser Permanente Washington Health Research Institute, Seattle (J.D., E.L., D.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanfei","family":"Zhang","sequence":"additional","affiliation":[{"name":"Genomic Medicine Institute, Geisinger Health System, Danville, PA (M.T.M.L., Y.Z.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gail P.","family":"Jarvik","sequence":"additional","affiliation":[{"name":"Division of Medical Genetics, Departments of Medicine and Genome Sciences (G.P.J.), University of Washington, Seattle."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2801-233X","authenticated-orcid":true,"given":"Ali G.","family":"Gharavi","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Center for Precision Medicine and Genomics, Columbia University, New York, NY (A.G.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8463-1939","authenticated-orcid":true,"given":"John","family":"Harley","sequence":"additional","affiliation":[{"name":"Center for Autoimmune Genomics and Etiology (CAGE), Cincinnati Children\u2019s Hospital Medical Center, OH (J.H.)."},{"name":"Department of Pediatrics, University of Cincinnati College of Medicine, OH (J.H.)."},{"name":"US Department of Veterans Affairs, Cincinnati, OH (J.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Mentch","sequence":"additional","affiliation":[{"name":"Center for Applied Genomics, The Children\u2019s Hospital of Philadelphia, PA (F.M., H.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer A.","family":"Pacheco","sequence":"additional","affiliation":[{"name":"Center for Genetic Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (J.A.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hakon","family":"Hakonarson","sequence":"additional","affiliation":[{"name":"Department of Pediatrics (H.H.), Perelman School of Medicine, University of Pennsylvania, Philadelphia."},{"name":"Center for Applied Genomics, The Children\u2019s Hospital of Philadelphia, PA (F.M., H.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne Heidi","family":"Skogholt","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health Sciences (A.H.S., L.T., M.E.G., K.H., J.B.N.), Norwegian University of Science and Technology, Trondheim, Norway."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0548-2486","authenticated-orcid":true,"given":"Laurent","family":"Thomas","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health Sciences (A.H.S., L.T., M.E.G., K.H., J.B.N.), Norwegian University of Science and Technology, Trondheim, Norway."},{"name":"Department of Clinical and Molecular Medicine (L.T.), Norwegian University of Science and Technology, Trondheim, Norway."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maiken Elvestad","family":"Gabrielsen","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health Sciences (A.H.S., L.T., M.E.G., K.H., J.B.N.), Norwegian University of Science and Technology, Trondheim, Norway."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristian","family":"Hveem","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health Sciences (A.H.S., L.T., M.E.G., K.H., J.B.N.), Norwegian University of Science and Technology, Trondheim, Norway."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6654-2852","authenticated-orcid":true,"given":"Jonas Bille","family":"Nielsen","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health Sciences (A.H.S., L.T., M.E.G., K.H., J.B.N.), Norwegian University of Science and Technology, Trondheim, Norway."},{"name":"K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Department of Epidemiology Research, Statens Serum Institute, Copenhagen, Denmark (J.B.N.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Zhou","sequence":"additional","affiliation":[{"name":"Center for Genomic Medicine (D.K., W.Z., P.N.), Massachusetts General Hospital, Harvard Medical School, Boston."},{"name":"Stanley Center for Psychiatric Research (W.Z.), Broad Institute of MIT and Harvard, Cambridge, MA."},{"name":"Analytic and Translational Genetics Unit (W.Z.), Massachusetts General Hospital, Boston."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2110-1690","authenticated-orcid":true,"given":"Lars","family":"Fritsche","sequence":"additional","affiliation":[{"name":"Department of Biostatistics (L.F.), University of Michigan Medical School, Ann Arbor."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Huang","sequence":"additional","affiliation":[{"name":"Boston VA Healthcare System, MA (J.H., P.N., K.C., C.J.O.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8402-7435","authenticated-orcid":true,"given":"Pradeep","family":"Natarajan","sequence":"additional","affiliation":[{"name":"Center for Genomic Medicine (D.K., W.Z., P.N.), Massachusetts General Hospital, Harvard Medical School, Boston."},{"name":"Department of Medicine (P.N.), Massachusetts General Hospital, Harvard Medical School, Boston."},{"name":"Cardiovascular Research Center (P.N.), Massachusetts General Hospital, Boston."},{"name":"Boston VA Healthcare System, MA (J.H., P.N., K.C., C.J.O.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan V.","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA (Y.V.S.)."},{"name":"Atlanta VA Health Care System, Decatur, GA (Y.V.S., P.W.F.W.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott L.","family":"DuVall","sequence":"additional","affiliation":[{"name":"VA Informatics and Computing Infrastructure, VA Salt Lake City Health Care System, UT (J.L., S.L.D.)."},{"name":"Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City (S.L.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9245-9876","authenticated-orcid":true,"given":"Daniel J.","family":"Rader","sequence":"additional","affiliation":[{"name":"Department of Medicine (M.G.L., D.J.R., K.-M.C.), Perelman School of Medicine, University of Pennsylvania, Philadelphia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly","family":"Cho","sequence":"additional","affiliation":[{"name":"Boston VA Healthcare System, MA (J.H., P.N., K.C., C.J.O.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyong-Mi","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Medicine (M.G.L., D.J.R., K.-M.C.), Perelman School of Medicine, University of Pennsylvania, Philadelphia."},{"name":"Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA (R.J., M.G.L., K.-M.C., S.M.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5653-7056","authenticated-orcid":true,"given":"Peter W.F.","family":"Wilson","sequence":"additional","affiliation":[{"name":"Atlanta VA Health Care System, Decatur, GA (Y.V.S., P.W.F.W.)."},{"name":"Emory Clinical Cardiovascular Research Institute, Atlanta, GA (P.W.F.W.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher J.","family":"O\u2019Donnell","sequence":"additional","affiliation":[{"name":"Boston VA Healthcare System, MA (J.H., P.N., K.C., C.J.O.)."},{"name":"Cardiovascular Medicine Division, Department of Medicine, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, MA (C.J.O.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3711-7101","authenticated-orcid":true,"given":"Sekar","family":"Kathiresan","sequence":"additional","affiliation":[{"name":"Verve Therapeutics, Cambridge, MA (S.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salvatore T.","family":"Scali","sequence":"additional","affiliation":[{"name":"Malcolm Randall VA Medical Center, Gainesville, FL (D.K., S.T.S., S.A.B.)."},{"name":"Division of Vascular Surgery and Endovascular Therapy, University of Florida College of Medicine, Gainesville (D.K., S.T.S., S.A.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott A.","family":"Berceli","sequence":"additional","affiliation":[{"name":"Malcolm Randall VA Medical Center, Gainesville, FL (D.K., S.T.S., S.A.B.)."},{"name":"Division of Vascular Surgery and Endovascular Therapy, University of Florida College of Medicine, Gainesville (D.K., S.T.S., S.A.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristen","family":"Willer","sequence":"additional","affiliation":[{"name":"Department of Computational Medicine and Bioinformatics (B.N.W., C.W.), University of Michigan Medical School, Ann Arbor."},{"name":"Department of Internal Medicine, Division of Cardiology (C.W.), University of Michigan Medical School, Ann Arbor."},{"name":"Department of Human Genetics (C.W.), University of Michigan Medical School, Ann Arbor."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6950-4210","authenticated-orcid":true,"given":"Gregory T.","family":"Jones","sequence":"additional","affiliation":[{"name":"Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, New Zealand (G.T.J.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew J.","family":"Bown","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Sciences and NIHR Leicester Biomedical Research Centre, University of Leicester, United Kingdom (M.J.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Girish","family":"Nadkarni","sequence":"additional","affiliation":[{"name":"Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY (I.P., G.N.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6524-3471","authenticated-orcid":true,"given":"Iftikhar J.","family":"Kullo","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN (O.D., I.J.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marylyn","family":"Ritchie","sequence":"additional","affiliation":[{"name":"Department of Genetics (S.S.V., M.R.), Perelman School of Medicine, University of Pennsylvania, Philadelphia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8009-1632","authenticated-orcid":true,"given":"Scott M.","family":"Damrauer","sequence":"additional","affiliation":[{"name":"Department of Surgery (R.J., S.M.D.), Perelman School of Medicine, University of Pennsylvania, Philadelphia."},{"name":"Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA (R.J., M.G.L., K.-M.C., S.M.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7274-9318","authenticated-orcid":true,"given":"Philip S.","family":"Tsao","sequence":"additional","affiliation":[{"name":"VA Palo Alto Health Care System (C.T., J.M.S., T.L.A., P.S.T.), CA."},{"name":"Division of Cardiovascular Medicine, Department of Medicine (C.T., J.M.S., T.L.A., P.S.T.), Stanford University School of Medicine, CA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. Michael","family":"Gaziano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Ramoni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean","family":"Beckham","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jim","family":"Breeling","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyong-Mi","family":"Chang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grant","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sumitra","family":"Muralidhar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher J.","family":"O\u2019Donnell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.P.","family":"Casas Romero","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip S.","family":"Tsao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sumitra","family":"Muralidhar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Moser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stacey B.","family":"Whitbourne","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica V.","family":"Brewer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Concato","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stuart","family":"Warren","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dean P.","family":"Argyres","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip S.","family":"Tsao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. Michael","family":"Gaziano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brady","family":"Stephens","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary T.","family":"Brophy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donald E.","family":"Humphries","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nhan","family":"Do","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shahpoor","family":"Shayan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuan-Mai T.","family":"Nguyen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher J.","family":"O\u2019Donnell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saiju","family":"Pyarajan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip S.","family":"Tsao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly","family":"Cho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saiju","family":"Pyarajan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Hauser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Sun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongyu","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Wilson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"McArdle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louis","family":"Dellitalia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Harley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clement J.","family":"Zablocki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey","family":"Whittle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean","family":"Beckham","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Wells","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salvador","family":"Gutierrez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gretchen","family":"Gibson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurence","family":"Kaminsky","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerardo","family":"Villareal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott","family":"Kinlay","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junzhe","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Hamner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathlyn Sue","family":"Haddock","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sujata","family":"Bhushan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pran","family":"Iruvanti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Godschalk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zuhair","family":"Ballas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malcolm","family":"Buford","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Mastorides","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jon","family":"Klein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nora","family":"Ratcliffe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hermes","family":"Florez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan","family":"Swann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maureen","family":"Murdoch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peruvemba","family":"Sriram","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shing Shing","family":"Yeh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronald","family":"Washburn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darshana","family":"Jhala","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel","family":"Aguayo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Cohen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satish","family":"Sharma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Callaghan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kris Ann","family":"Oursler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary","family":"Whooley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sunil","family":"Ahuja","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amparo","family":"Gutierrez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronald","family":"Schifman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Greco","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Rauchman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Servatius","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary","family":"Oehlert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agnes","family":"Wallbom","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronald","family":"Fernando","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy","family":"Morgan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Todd","family":"Stapley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott","family":"Sherman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gwenevere","family":"Anderson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip","family":"Tsao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elif","family":"Sonel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward","family":"Boyko","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurence","family":"Meyer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samir","family":"Gupta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Fayad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adriana","family":"Hung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jack","family":"Lichy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robin","family":"Hurley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brooks","family":"Robey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Striker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.113.005457"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCRESAHA.118.312436"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2009.08.036"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1038\/ng.622"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajhg.2011.10.002"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCGENETICS.113.000165"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCRESAHA.116.308765"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)60404-8"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2015.09.016"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-019-0492-5"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41588-019-0519-3"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1186\/1755-8794-4-13"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2018.2287"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1038\/nbt.2749"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1093\/bioinformatics\/btu197"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1038\/ng.3406"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.1038\/nature09270"},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.1038\/ng.3396"},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.1093\/bioinformatics\/btw613"},{"key":"e_1_3_4_21_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41588-018-0307-5"},{"key":"e_1_3_4_22_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41588-018-0205-x"},{"key":"e_1_3_4_23_2","doi-asserted-by":"publisher","DOI":"10.1097\/EDE.0000000000000559"},{"key":"e_1_3_4_24_2","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyv080"},{"key":"e_1_3_4_25_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41588-018-0099-7"},{"key":"e_1_3_4_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2017.10.044"},{"key":"e_1_3_4_27_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41588-018-0184-y"},{"key":"e_1_3_4_28_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-017-00802-2"},{"key":"e_1_3_4_29_2","doi-asserted-by":"publisher","DOI":"10.1093\/bioinformatics\/btq340"},{"key":"e_1_3_4_30_2","doi-asserted-by":"publisher","DOI":"10.1038\/nature15393"},{"key":"e_1_3_4_31_2","unstructured":"R Development Core Team. R: A language and environment for statistical computing. Vienna Austria: R Foundation for Statistical Computing; 2008."},{"key":"e_1_3_4_32_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41588-018-0222-9"},{"key":"e_1_3_4_33_2","doi-asserted-by":"publisher","DOI":"10.1038\/nature06846"},{"key":"e_1_3_4_34_2","doi-asserted-by":"publisher","DOI":"10.1126\/science.aap8757"},{"key":"e_1_3_4_35_2","doi-asserted-by":"publisher","DOI":"10.5339\/gcsp.2013.10"},{"key":"e_1_3_4_36_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)60685-1"},{"key":"e_1_3_4_37_2","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.111.00275"},{"key":"e_1_3_4_38_2","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A4827"},{"key":"e_1_3_4_39_2","doi-asserted-by":"publisher","DOI":"10.1067\/mva.2000.105955"},{"key":"e_1_3_4_40_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2008.11.025"},{"key":"e_1_3_4_41_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2012.12.034"},{"key":"e_1_3_4_42_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2019.18928"},{"key":"e_1_3_4_43_2","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800820821"},{"key":"e_1_3_4_44_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(02)11522-4"},{"key":"e_1_3_4_45_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.38272.478438.55"},{"key":"e_1_3_4_46_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.38369.620162.82"},{"key":"e_1_3_4_47_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajhg.2020.03.004"},{"key":"e_1_3_4_48_2","doi-asserted-by":"publisher","DOI":"10.1038\/ng.3571"},{"key":"e_1_3_4_49_2","doi-asserted-by":"publisher","DOI":"10.1038\/ng.2354"},{"key":"e_1_3_4_50_2","doi-asserted-by":"publisher","DOI":"10.1038\/ng1847"},{"key":"e_1_3_4_51_2","doi-asserted-by":"publisher","DOI":"10.1101\/gr.094052.109"},{"key":"e_1_3_4_52_2","doi-asserted-by":"publisher","DOI":"10.1093\/bioinformatics\/btq559"},{"key":"e_1_3_4_53_2","doi-asserted-by":"publisher","DOI":"10.1086\/519795"},{"key":"e_1_3_4_54_2","doi-asserted-by":"publisher","DOI":"10.1038\/ng.3643"},{"key":"e_1_3_4_55_2","doi-asserted-by":"publisher","DOI":"10.1002\/gepi.22167"}],"container-title":["Circulation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/CIRCULATIONAHA.120.047544","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T07:35:42Z","timestamp":1715585742000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/CIRCULATIONAHA.120.047544"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10,27]]},"references-count":54,"journal-issue":{"issue":"17","published-print":{"date-parts":[[2020,10,27]]}},"alternative-id":["10.1161\/CIRCULATIONAHA.120.047544"],"URL":"https:\/\/doi.org\/10.1161\/circulationaha.120.047544","relation":{},"ISSN":["0009-7322","1524-4539"],"issn-type":[{"value":"0009-7322","type":"print"},{"value":"1524-4539","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,10,27]]},"assertion":[{"value":"2020-04-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-07-23","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-09-28","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}