# Prevalence, Incidence, and Predictors of Subclinical and Clinical Vascular and Myocardial Disease: Pathophysiologic Pathways

> **NIH NIH P01** · EMORY UNIVERSITY · 2022 · $113,721

## Abstract

PROJECT SUMMARY / ABSTRACT: Project 1
 The overarching goal of Project 1 is to study the prevalence, incidence, pathophysiology and predictors of
sub-clinical and clinical vascular and myocardial disease in South Asian individuals with and without “traditional”
cardiovascular disease (CVD). There are well-recognized gaps in understanding contributors to the increased
atherosclerotic CVD (ASCVD) and heart failure (HF) risk in South Asians, a population at high risk at a younger
age, despite relatively low body mass index, and with a high prevalence of type 2 diabetes, dyslipidemia,
hypertension, and hepatic steatosis. Available predictive algorithms for evaluation of risk under-estimate ASCVD
risk in South Asians. The prevalence of HF, including both HF with reduced (HFrEF) and preserved (HFpEF)
ejection fraction is also rising in this population. However, there are few population-based studies with
longitudinal data available in the SA population. In Project 1 of Precision-CARRS, we will leverage and build
upon a unique resource and scientific opportunity, the ongoing Center for cArdiometabolic Risk Reduction in
South Asia (CARRS) cohort, established with NHLBI funding, with 21,864 community-based participants
representative of two cities in India who have been followed for up to 10 years with high retention rates and a
biorepository. We propose to perform an additional 5 years of follow-up with careful phenotyping and accrue an
estimated 167,725 person-years of follow-up by 2025 with an estimated ~1,000 incident ASCVD and ~900 HF
cases. In Aim 1, we will study the prevalence of subclinical vascular disease and incidence of adverse ASCVD
events and their associations with longitudinally acquired ASCVD and metabolic risk factor data. We aim to
develop South Asian-specific predictive algorithms and validate them in independent cohorts. Sub-clinical
disease measures include arterial stiffness, coronary artery calcium score (CAC), carotid intima-media thickness
(CIMT) and carotid plaque. In Aim 2, we will determine the prevalence of subclinical left ventricular (LV)
dysfunction and clinical HF and their relationship with longitudinally measured ASCVD and metabolic risk factors.
Sub-clinical systolic and/or diastolic LV dysfunction will be measured using echocardiography and HF Stages
C/D (HFrEF / HFpEF) determined for clinical events. Our goal is to develop South Asian-specific predictive
algorithms for HF. In Aim 3, we will determine the relationship between advanced lipid measures, advanced
metabolic measures, including hepatic fat measurements and activation of specific pathophysiologic pathways
and the presence of (i) sub-clinical vascular and (ii) myocardial disease, and (iii) incident adverse ASCVD and HF
events. Activation of pathophysiologic pathways will be estimated from circulating protein biomarkers
(inflammation, immune dysregulation, thrombogenesis, myocardial ischemia/stretch). Our overall goal is to
augment the scientific value of the...

## Key facts

- **NIH application ID:** 10333816
- **Project number:** 1P01HL154996-01A1
- **Recipient organization:** EMORY UNIVERSITY
- **Principal Investigator:** ARSHED A QUYYUMI
- **Activity code:** P01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $113,721
- **Award type:** 1
- **Project period:** 2022-05-15 → 2027-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10333816

## Citation

> US National Institutes of Health, RePORTER application 10333816, Prevalence, Incidence, and Predictors of Subclinical and Clinical Vascular and Myocardial Disease: Pathophysiologic Pathways (1P01HL154996-01A1). Retrieved via AI Analytics 2026-05-29 from https://api.ai-analytics.org/grant/nih/10333816. Licensed CC0.

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