The Bangladesh Risk of Acute Vascular Events (BRAVE) Study: objectives and design.
During recent decades, Bangladesh has experienced a rapid epidemiological transition from communicable to non-communicable diseases. Coronary heart disease (CHD), with myocardial infarction (MI) as its main manifestation, is a major cause of death in the country. However, there is limited reliable evidence about its determinants in this population. The Bangladesh Risk of Acute Vascular Events (BRAVE) study is an epidemiological bioresource established to examine environmental, genetic, lifestyle and biochemical determinants of CHD among the Bangladeshi population. By early 2015, the ongoing BRAVE study had recruited over 5000 confirmed first-ever MI cases, and over 5000 controls "frequency-matched" by age and sex. For each participant, information has been recorded on demographic factors, lifestyle, socioeconomic, clinical, and anthropometric characteristics. A 12-lead electrocardiogram has been recorded. Biological samples have been collected and stored, including extracted DNA, plasma, serum and whole blood. Additionally, for the 3000 cases and 3000 controls initially recruited, genotyping has been done using the CardioMetabochip+ and the Exome+ arrays. The mean age (standard deviation) of MI cases is 53 (10) years, with 88 % of cases being male and 46 % aged 50 years or younger. The median interval between reported onset of symptoms and hospital admission is 5 h. Initial analyses indicate that Bangladeshis are genetically distinct from major non-South Asian ethnicities, as well as distinct from other South Asian ethnicities. The BRAVE study is well-placed to serve as a powerful resource to investigate current and future hypotheses relating to environmental, biochemical and genetic causes of CHD in an important but under-studied South Asian population.
Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK, brave@phpc.cam.ac.uk.
Rajiv
R
Chowdhury
Dewan S
DS
Alam
Ismail Ibrahim
II
Fakir
Sheikh Daud
SD
Adnan
Aliya
A
Naheed
Ishrat
I
Tasmin
Md Mostafa
MM
Monower
Farzana
F
Hossain
Fatema Mahjabin
FM
Hossain
Md Mostafizur
MM
Rahman
Sadia
S
Afrin
Anjan Kumar
AK
Roy
Minara
M
Akter
Sima Akter
SA
Sume
Ajoy Kumer
AK
Biswas
Lisa
L
Pennells
Praveen
P
Surendran
Robin D
RD
Young
Sarah A
SA
Spackman
Khaled
K
Hasan
Eric
E
Harshfield
Nasir
N
Sheikh
Richard
R
Houghton
Danish
D
Saleheen
Joanna M M
JM
Howson
Adam S
AS
Butterworth
Rubhana
R
Raqib
Abdulla Al Shafi
AA
Majumder
John
J
Danesh
Emanuele
E
Di Angelantonio
D000328:Adult; D000368:Aged; D044466:Asian People / Q000235:genetics*; D001459:Bangladesh; D016022:Case-Control Studies; D003324:Coronary Artery Disease / Q000208:ethnology / Q000235:genetics; D003327:Coronary Disease / Q000208:ethnology / Q000235:genetics*; D005260:Female; D005838:Genotype; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology; D012306:Risk; D012307:Risk Factors