title: Rationale, design & preliminary findings of the Indian Atherosclerosis Research Study.
abstract: OBJECTIVE
  Cardiovascular disease is highly prevalent among Asian Indians. The objective of the Indian Atherosclerosis Research Study (IARS) is to understand the molecular basis of Coronary Artery Disease (CAD) in this population.
  
  
  RESULTS
  Over 12,500 subjects from 2500 families and 2500 healthy matched controls will be enrolled by year 2010 in the IARS. Selection of participants will be based on stringent inclusion/exclusion criteria. Blood samples will be analyzed for various genes and biomarkers implicated in CAD by employing commercial or in-house developed assays as for indices of early vascular changes. To date, over 6053 individuals from 1644 families with associated demographics, clinical information and bio specimen have been enrolled and comprise of 2131 CAD patients with mean age, 55.02 +/- 0.19 years and 3901 unaffected relatives with mean age, 40.15 +/- 0.22 years. Over 70% of the CAD patients were males. There was significant association of diabetes, hypertension and smoking with CAD status (OR 2.43-4.75; 95% CI 2.01-5.59). Subjects with metabolic syndrome (MS) showed 3 times higher risk of CAD than the non MS group (OR 3.04; 95% CI 2.71-3.41). Preliminary analyses on various atherothrombotic genes relating to lipids, inflammation and growth have identified novel variants as well as unique haplotypes associated with CAD. Proteomic studies revealed strong heritability for plasma TG, IL6, hsCRP and HDL-c levels (h2 46%-86%; p < 0.01). Baseline levels of pro-inflammatory like CRP, sPLA2 and sTWEAK were significantly higher in patients with recurrent or new coronary event. Affected subjects had higher serum antibody titers to CMV, H. pylori and C Pneumoniae infections. Early results from non-invasive assessment of endothelial dysfunction using Periscope suggest that this method is a sensitive tool for delineation of sub clinical atherosclerosis.
  
  
  CONCLUSIONS
  The clinical and molecular data will be systematically integrated to develop a refined algorithm for risk prediction in the Asian Indian population.
authors.affiliation: Thrombosis Research Institute, India.
authors.forename: Jayashree
authors.initials: J
authors.lastname: Shanker
authors.forename: Arindam
authors.initials: A
authors.lastname: Maitra
authors.forename: Veena S
authors.initials: VS
authors.lastname: Rao
authors.forename: Lakshmi
authors.initials: L
authors.lastname: Mundkur
authors.forename: B
authors.initials: B
authors.lastname: Dhanalakshmi
authors.forename: Sridhar
authors.initials: S
authors.lastname: Hebbagodi
authors.forename: Vijay V
authors.initials: VV
authors.lastname: Kakkar
mesh_terms: D000328:Adult; D050197:Atherosclerosis / Q000097:blood / Q000453:epidemiology* / Q000235:genetics*; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D005260:Female; D023281:Genomics; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D015995:Prevalence; D011446:Prospective Studies; D040901:Proteomics; D012107:Research Design
chemical_list: D015415:Biomarkers