{"doi":"10.1016/j.xkme.2020.02.007","title":"APOL1 Risk Alleles, Cardiac Markers, and Risk of ESKD in African Americans: The Atherosclerosis Risk in Communities Study","abstract":"African Americans face a higher risk for chronic kidney disease and kidney failure compared with people of European ancestry. Part of this risk has been attributed to genetic factors. The presence of 2 risk alleles in the APOL1 gene, a genotype present in 13% of African Americans, is associated with 2-fold increased risk for end-stage kidney disease (ESKD).1Foster M.C. Coresh J. Fornage M. et al.APOL1 variants associate with increased risk of CKD among African Americans.J Am Soc Nephrol. 2013; 24: 1484-1491Crossref PubMed Scopus (183) Google Scholar However, not everyone with the high-risk genotype progresses to ESKD. It has been suggested that a “second hit,” an exposure that increases the risk of the APOL1 high-risk genotype, is required for kidney function decline.2Freedman B.I. Skorecki K. Gene-gene and gene-environment interactions in apolipoprotein L1 gene-associated nephropathy.Clin J Am Soc Nephrol. 2014; 9: 2006-2013Crossref PubMed Scopus (78) Google Scholar Cardiovascular damage could play a role in precipitating kidney function decline. Cardiac troponin T, troponin I, and N-terminal pro–brain natriuretic peptide (NT-proBNP) are markers of cardiac damage that are used in diagnosing myocardial infarction and heart failure and are increasingly recognized as prognostic markers, even at subclinical levels.3Saunders J.T. Nambi V. de Lemos J.A. et al.Cardiac troponin T measured by a highly sensitive assay predicts coronary heart disease, heart failure, and mortality in the Atherosclerosis Risk in Communities Study.Circulation. 2011; 123: 1367-1376Crossref PubMed Scopus (565) Google Scholar, 4Myhre P.L. Claggett B. Ballantyne C.M. et al.Association between circulating troponin concentrations, left ventricular systolic and diastolic functions, and incident heart failure in older adults.JAMA Cardiol. 2019; 4: 997-1006Crossref PubMed Scopus (31) Google Scholar, 5Ndumele C.E. Matsushita K. Sang Y. et al.NT-proBNP and heart failure risk among individuals with and without obesity: the ARIC Study.Circulation. 2016; 133: 631-638Crossref PubMed Scopus (73) Google Scholar High-sensitivity cardiac troponin T (hs-cTnT) and NT-proBNP have been associated with ESKD.6Kim Y. Matsushita K. Sang Y. et al.Association of high-sensitivity cardiac troponin T and natriuretic peptide with incident ESRD: the Atherosclerosis Risk in Communities (ARIC) study.Am J Kidney Dis. 2015; 65: 550-558Abstract Full Text Full Text PDF PubMed Scopus (14) Google Scholar The APOL1 gene is widely expressed, including in the vasculature. A recent study7Grams M.E. Surapaneni A. Ballew S.H. et al.APOL1 kidney-risk variants and cardiovascular disease: an individual participant data meta-analysis.J Am Soc Nephrol. 2019; 30: 2027-2036Crossref PubMed Scopus (18) Google Scholar suggested minimal association between APOL1 genotype and clinical cardiovascular disease; however, this has not been tested using the more sensitive markers of subclinical disease, such as hs-cTnT, high-sensitivity troponin I (hs-TnI), and NT-proBNP. Using data from African American participants in the Atherosclerosis Risk in Communities (ARIC) Study,8The Atherosclerosis Risk in Communities (ARIC) Study: design and objectives. The ARIC investigators.Am J Epidemiol. 1989; 129: 687-702Crossref PubMed Scopus (2865) Google Scholar we examined the associations of APOL1 genotypes with these cardiac markers and tested whether higher levels increased the risk of APOL1 associated with ESKD. The ARIC Study is a prospective community-based cohort of adults aged 45 to 64 years that began in 1987. For this study, only African American participants without prevalent ESKD consenting to genotyping were included (N = 2,992). Hs-cTnT and NT-proBNP were assayed at study visit 2 (1990-1992), which was considered the baseline for our study, and visits 4 (1996-1998), 5 (2011-2013), and 6 (2016-2017; Item S1). We tested cross-sectional differences in cardiac markers by APOL1 genotype using Wilcoxon rank sum tests. For lon","journal":"Kidney Medicine","year":2020,"id":116707,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":1,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9567,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":48275,"name":"Shoshana H. Ballew","orcid":"0000-0002-7547-3764","position":1,"is_corresponding":false},{"id":23021,"name":"Josef Coresh","orcid":"0000-0002-4598-0669","position":2,"is_corresponding":false},{"id":233725,"name":"Christie M. Ballantyne","orcid":"0000-0002-6432-1730","position":3,"is_corresponding":false},{"id":266269,"name":"Elizabeth Selvin","orcid":"0000-0001-6923-7151","position":4,"is_corresponding":false},{"id":22652,"name":"Kunihiro Matsushita","orcid":"0000-0002-7179-718X","position":5,"is_corresponding":false},{"id":73169,"name":"Morgan E. Grams","orcid":"0000-0002-4430-6023","position":6,"is_corresponding":false},{"id":232664,"name":"Aditya Surapaneni","orcid":"0000-0003-4978-5980","position":0,"is_corresponding":true}],"reference_count":9,"raw_metadata":null,"created_at":"2026-07-18T23:13:47.803267Z","pmid":"32775995","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}