# Precision Cardiovascular Diseases Phenotyping and Pathophysiological Pathways in the CARRS Cohort (Precision-CARRS)

> **NIH NIH P01** · EMORY UNIVERSITY · 2023 · $2,289,655

## Abstract

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.

## Key facts

- **NIH application ID:** 10622446
- **Project number:** 5P01HL154996-02
- **Recipient organization:** EMORY UNIVERSITY
- **Principal Investigator:** Kabayam M Venkat Narayan
- **Activity code:** P01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2023
- **Award amount:** $2,289,655
- **Award type:** 5
- **Project period:** 2022-05-15 → 2027-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10622446

## Citation

> US National Institutes of Health, RePORTER application 10622446, Precision Cardiovascular Diseases Phenotyping and Pathophysiological Pathways in the CARRS Cohort (Precision-CARRS) (5P01HL154996-02). Retrieved via AI Analytics 2026-05-28 from https://api.ai-analytics.org/grant/nih/10622446. Licensed CC0.

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