Unveiling the Genetic Landscape of Coronary Artery Disease Through Common and Rare Structural Variants

J Am Heart Assoc. 2025 Feb 18;14(4):e036499. doi: 10.1161/JAHA.124.036499. Epub 2025 Feb 14.

Abstract

Background: Genome-wide association studies have identified several hundred susceptibility single nucleotide variants for coronary artery disease (CAD). Despite single nucleotide variant-based genome-wide association studies improving our understanding of the genetics of CAD, the contribution of structural variants (SVs) to the risk of CAD remains largely unclear.

Method and results: We leveraged SVs detected from high-coverage whole genome sequencing data in a diverse group of participants from the National Heart Lung and Blood Institute's Trans-Omics for Precision Medicine program. Single variant tests were performed on 58 706 SVs in a study sample of 11 556 CAD cases and 42 907 controls. Additionally, aggregate tests using sliding windows were performed to examine rare SVs. One genome-wide significant association was identified for a common biallelic intergenic duplication on chromosome 6q21 (P=1.54E-09, odds ratio=1.34). The sliding window-based aggregate tests found 1 region on chromosome 17q25.3, overlapping USP36, to be significantly associated with coronary artery disease (P=1.03E-10). USP36 is highly expressed in arterial and adipose tissues while broadly affecting several cardiometabolic traits.

Conclusions: Our results suggest that SVs, both common and rare, may influence the risk of coronary artery disease.

Keywords: association testing; coronary artery disease; genetics; structural variants; whole‐genome sequencing.

MeSH terms

  • Aged
  • Case-Control Studies
  • Chromosomes, Human, Pair 6 / genetics
  • Coronary Artery Disease* / diagnosis
  • Coronary Artery Disease* / genetics
  • Female
  • Genetic Predisposition to Disease
  • Genome-Wide Association Study
  • Genomic Structural Variation*
  • Humans
  • Male
  • Middle Aged
  • Phenotype
  • Polymorphism, Single Nucleotide
  • Risk Factors
  • Whole Genome Sequencing