Concordance of genetic determinants of acute coronary artery disease between European and Chinese populations

AIMS: This study examined the concordance of associations of single nucleotide polymorphisms (SNPs) for acute coronary artery disease (CAD) discovered in Europeans with acute CAD, chronic ischaemic heart disease (IHD) or stroke in Chinese adults. METHODS: In a nested case-control study of acute CAD (4748 cases/66,227 controls) in China Kadoorie Biobank (CKB), we compared associations of 224 SNPs for acute CAD discovered in Europeans in CARDIOGRAMplusC4D (CC4D) with acute CAD in Chinese. We compared associations of a genetic score (GS-CAD) for 224 SNPs for acute CAD with chronic IHD (n=9000), heart failure (n=1229), stroke (n=10,208) and CVD risk factors (n=70,364) and plasma proteomics (n=3904) in CKB. RESULTS: The strength of associations of 224 CAD SNPs discovered in Europeans was moderately correlated with those for acute CAD in Chinese (r=0.53), but significant associations were only replicated (p<0.05) for 25 SNPs. The strength of associations with acute CAD for a 1 SD higher genetic score for acute CAD in Chinese were 3-fold greater than for chronic IHD or heart failure (1.22 [1.18-1.26] vs 1.07 [1.05-1.10] vs 1.06 [1.00-1.12], respectively) and 7-fold greater than for stroke (1.03; 1.01-1.05). Higher levels of GS-CAD were strongly associated with LDL-cholesterol (LDL-C), moderately with systolic blood pressure (SBP) and weakly with body mass index (BMI), but not with proteomics. CONCLUSIONS: The findings demonstrate a moderate concordance of genetic determinants for acute CAD between Europeans and Chinese that were specific for CAD and only weakly associated with chronic IHD, heart failure or ischaemic stroke.