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Principal Investigator: Kabayam M Venkat Narayan
Organization: EMORY UNIVERSITY
Fiscal Year: 2024
Award: $2,211,138
Funding agency: National Heart Lung and Blood Institute
PROJECT SUMMARY / ABSTRACT (Overall)
Precision-CARRS will revolutionize the cardiovascular disease (CVD) prevention and care paradigm from
imprecise prediction with focus on late stage disease to personalized and precise prediction with improved
understanding of early-stage disease to maintain cardiovascular health. Atherosclerotic CVD (ASCVD) and
heart failure (HF) phenotypes are heterogeneous and result from complex interactions between immutable
genetic factors and mutable forces operating at environmental (e.g., ambient air quality), individual (e.g.,
health behaviors, social influence), and molecular (e, g, proteins, 'omics) levels. South Asians are an
understudied population at high CVD risk even at young ages, at low body weight, and in the absence of
traditional risk factors. We will leverage substantial matched resources, and also build upon the NHLBI-
funded CARRS cohort, a representative sample of n=21,864 South Asians aged ≥ 20 years, with ongoing
follow-up for clinical ASCVD risk factors, clinical disease, and mortality. The cohort has high retention (>95%
have at least one follow-up) and a biorepository of 360,000 stored samples. We will add detailed subclinical
and clinical CVD phenotyping, repeated measures of targeted protein markers and untargeted multi-omics,
and real-time assessment of health behaviors. By extending follow-up by an additional 5 years, we will
accrue 176,536 person-years of follow up, >1,000 incident ASCVD, and nearly >900 cases of clinical HF
(Stages C/D). Enabled by precise mapping of CVD at the granular level of subclinical and clinical
phenotypes, we will investigate the epidemiology and causes of CVD along both ASCVD and HF pathways.
Three complementary cores (Administrative and Field Coordination; CVD Phenotyping; and Data
Management and Analysis) will support four interconnected projects, one of which is led by an early-stage
investigator (ESI). All four project examine common subclinical and clinical endpoints from synergistic vantage
points: traditional risk factors and targeted protein-based pathophysiological pathways (Project 1), the impact
of air pollution and mediating mechanisms (Project 2), molecular signals and mechanisms through integrative
untargeted multi-omics (Project 3), and socio-behavioral influences on CVD risk and outcomes studied via
spousal dyads (Project 4, ESI). Precision-CARRS will unravel the natural history, pathophysiology, and
causal factors of vascular and myocardial disease and pave the way for precision CVD diagnostics,
prevention, and care for South Asians–who represent one fifth of humanity and are a rapidly growing sub-
population in the US. In summary, Precision-CARRS is designed to be a powerful platform to understand the
natural history of CVD in an understudied high-risk population and to spur future innovative scientific
collaborations with other CVD longitudinal cohorts in the US and globally.
Terms: <21+ years old><Active Follow-up><Adult><Adult Human><Age><Air><Air Pollution><Apoplexy><Asia><Atherosclerosis><Atherosclerotic Cardiovascular Disease><Automobile Driving><Behavior><Behavioral><Biological><Body Weight><Brain Vascular Accident><COVID-19><CV-19><CVD prevention><Cardiac Diseases><Cardiac Disorders><Cardiac infarction><Cardiomyopathies><Cardiovascular Diseases><Caring><Causality><Cell Communication and Signaling><Cell Signaling><Cerebral Stroke><Cerebrovascular Apoplexy><Cerebrovascular Stroke><Cessation of life><Clinical><Collaborations><Complex><Coronavirus Infectious Disease 2019><Coupling><Data><Data Analyses><Data Analysis><Data Analytics><Data Collection><Death><Detection><Development><Diabetes Mellitus><Disease><Disease Outcome><Disease Pathway><Disorder><Dysfunction><Dyslipidemias><Environmental Exposure><Epidemiology><Etiology><Event><Fatty Liver><Functional disorder><Funding><Future><Genetic><Goals><Health behavior><Heart Diseases><Heart failure><Heterogeneity><Humanities><Hybrids><Immune Diseases><Immune Disorders><Immune Dysfunction><Immune System Diseases><Immune System Disorder><Immune System Dysfunction><Immune System and Related Disorders><Immunodeficiency and Immunosuppression Disorders><Immunologic Diseases><Immunological Diseases><Immunological Dysfunction><Immunological System Dysfunction><Incidence><India><Individual><Inflammation><Intracellular Communication and Signaling><Investigation><Investigators><Knowledge><Lead><Leanness><Liver Steatosis><Long-term cohort><Longitudinal cohort><Longterm cohort><Maps><Measures><Mediating><Molecular><Myocardial Diseases><Myocardial Disorder><Myocardial Infarct><Myocardial Infarction><Myocardiopathies><NHLBI><National Heart, Lung, and Blood Institute><Natural History><Outcome Study><P01 Mechanism><P01 Program><Pathogenicity><Pathway interactions><Pattern><Pb element><Persons><Phenotype><Physiopathology><Population><Population Heterogeneity><Predicting Risk><Prevalence><Prevention><Program Project Grant><Program Research Project Grants><Proteins><Research><Research Personnel><Research Program Projects><Research Resources><Researchers><Resource Sharing><Resources><Risk><Risk Factors><Risk Reduction><Role><Sampling><Signal Transduction><Signal Transduction Systems><Signaling><Social Behavior><South Asian><Stroke><Thinness><Time><Variant><Variation><Vascular Diseases><Vascular Disorder><acquired factor><active followup><adulthood><aged><ages><atheromatosis><atherosclerotic disease><atherosclerotic vascular disease><behavior influence><behavioral influence><biobank><biologic><biological signal transduction><biorepository><blood vessel disorder><brain attack><built environment><cardiac disease prevention><cardiac disease risk><cardiac disorder risk><cardiac failure><cardiac infarct><cardiometabolic risk><cardiovascular disease prevention><cardiovascular disease risk><cardiovascular disorder><cardiovascular disorder prevention><cardiovascular disorder risk><cardiovascular health><cardiovascular risk><cardiovascular risk factor><causation><cerebral vascular accident><cerebrovascular accident><clinical phenotype><cohort><coronary attack><coronary infarct><coronary infarction><coronavirus disease 2019><coronavirus disease-19><coronavirus infectious disease-19><data interpretation><data management><design><designing><developmental><diabetes><diabetes risk><disease causation><disease diagnostic><disease phenotype><disease risk><disorder risk><diverse populations><driving><epidemiologic><epidemiological><follow up><follow-up><followed up><followup><forecasting risk><health assessment><health related behavior><heart attack><heart disease risk><heart disorder><heart disorder risk><heart infarct><heart infarction><heavy metal Pb><heavy metal lead><hepatic steatosis><hepatosteatosis><heterogeneous population><high risk><high risk group><high risk individual><high risk people><high risk population><improved><innovate><innovation><innovative><insight><mortality><multiomics><multiple omics><myocardium disease><myocardium disorder><panomics><pathophysiology><pathway><population based><population diversity><predict risk><predict risks><predicted risk><predicted risks><predicting risks><predictive risk><predicts risk><prevent><preventing><programs><protein biomarkers><protein markers><public health relevance><recruit><reduce risk><reduce risks><reduce that risk><reduce the risk><reduce these risks><reduces risk><reduces the risk><reducing risk><reducing the risk><retention rate><retention strategy><risk prediction><risk predictions><risk-reducing><social factors><social influence><social role><sociobehavior><sociobehavioral><stroked><strokes><vascular dysfunction><vasculopathy>