Systems genetics analysis of genome-wide association study reveals novel associations between key biological processes and coronary artery disease

Sujoy Ghosh, Juan Vivar, Christopher P. Nelson, Christina Willenborg, Ayellet V. Segrè, Ville Petteri Mäkinen, Majid Nikpay, Jeannette Erdmann, Stefan Blankenberg, Christopher O'Donnell, Winfried März, Reijo Laaksonen, Alexandre F.R. Stewart, Stephen E. Epstein, Svati H. Shah, Christopher B. Granger, Stanley L. Hazen, Sekar Kathiresan, Muredach P. Reilly, Xia YangThomas Quertermous, Nilesh J. Samani, Heribert Schunkert, Themistocles L. Assimes, Ruth McPherson

Research output: Contribution to journalArticlepeer-review

63 Citations (Scopus)


Objective-Genome-wide association studies have identified multiple genetic variants affecting the risk of coronary artery disease (CAD). However, individually these explain only a small fraction of the heritability of CAD and for most, the causal biological mechanisms remain unclear. We sought to obtain further insights into potential causal processes of CAD by integrating large-scale GWA data with expertly curated databases of core human pathways and functional networks. Approaches and Results-Using pathways (gene sets) from Reactome, we carried out a 2-stage gene set enrichment analysis strategy. From a meta-analyzed discovery cohort of 7 CAD genome-wide association study data sets (9889 cases/11 089 controls), nominally significant gene sets were tested for replication in a meta-analysis of 9 additional studies (15 502 cases/55 730 controls) from the Coronary ARtery DIsease Genome wide Replication and Meta-analysis (CARDIoGRAM) Consortium. A total of 32 of 639 Reactome pathways tested showed convincing association with CAD (replication P<0.05). These pathways resided in 9 of 21 core biological processes represented in Reactome, and included pathways relevant to extracellular matrix (ECM) integrity, innate immunity, axon guidance, and signaling by PDRF (platelet-derived growth factor), NOTCH, and the transforming growth factor-β/SMAD receptor complex. Many of these pathways had strengths of association comparable to those observed in lipid transport pathways. Network analysis of unique genes within the replicated pathways further revealed several interconnected functional and topologically interacting modules representing novel associations (eg, semaphoring-regulated axonal guidance pathway) besides confirming known processes (lipid metabolism). The connectivity in the observed networks was statistically significant compared with random networks (P<0.001). Network centrality analysis (degree and betweenness) further identified genes (eg, NCAM1, FYN, FURIN, etc) likely to play critical roles in the maintenance and functioning of several of the replicated pathways. Conclusions-These findings provide novel insights into how genetic variation, interpreted in the context of biological processes and functional interactions among genes, may help define the genetic architecture of CAD.

Original languageEnglish
Pages (from-to)1712-1722
Number of pages11
JournalArteriosclerosis, Thrombosis, and Vascular Biology
Issue number7
Publication statusPublished or Issued - 27 Jul 2015
Externally publishedYes


  • coronary artery disease
  • pathway analysis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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