Carlos Iribarren, MD, MPH, PhD

People

Kaiser Permanente Division of Research
2000 Broadway
Oakland, CA 94612

(510) 891-3554 (phone)
carlos.iribarren@kp.org
Kaiser Permanente Researcher Profiles

Carlos Iribarren MD, MPH, PhD, is a Research Scientist at the Kaiser Permanente Northern California Division of Research and an adjunct Assistant Professor in the Department of Epidemiology and Biostatistics at the University of California, San Francisco (UCSF). He joined the Division of Research in 1997, and started at UCSF in 1998. A clinical epidemiologist, Dr. Iribarren's current research interests include risk stratification in the primary prevention setting, including genomic, imaging, and blood biomarkers, and the epidemiology of ECG traits (particularly QT interval) and chronic lung disease (asthma, interstitial pulmonary fibrosis). Dr. Iribarren was a standing member and co-chair of the NIH Cardiovascular, Heart and Sleep Study Section (CHS-B) from 2017-2021 and has participated in numerous other study sections, such as the American Heart Association Behavioral Science, Epidemiology, and Prevention Study Section. He is a Consultant for the Health Care Advisors and for Abbott Diagnostics. He was a Fulbright Fellow at the University of Southern California, Los Angeles, from 1989 through 1994. Dr. Iribarren has published over 210 peer-reviewed articles.

Current Position(s):

Research Scientist III, Division of Research, Kaiser Permanente Northern California
Adjunct Assistant Professor, Department of Epidemiology and Biostatistics, University of California, San Francisco

Section Affiliations:

Cardiovascular and Metabolic Conditions

Primary Research Interests:

Cardiovascular epidemiology
Genetic determinants of coronary heart disease
Vascular calcification
Psychosocial factors in coronary disease
Smoking-related diseases
Inflammation and endothelial function
Congestive heart failure in diabetes

Studies

Optimization of statin regimens for atherosclerotic cardiovascular disease prevention using polygenic risk scores and real-world evidence

Using the GERA cohort, we aim to determine the extent to which atherosclerotic cardiovascular disease (ASCVD) polygenic risk score is associated with baseline ASCVD risk and statin-induced ASCVD relative risk reduction. We will also determine the extent to which the association between ASCVD polygenic risk score and statin-induced ASCVD relative risk reduction is modified by statin benefit group, statin type, and statin dose. Lastly, we will develop an algorithm that predicts baseline ASCVD and statin-induced ASCVD relative risk reduction incorporating ASCVD polygenic risk score on top of traditional ASCVD risk prediction tools. The goal is to use these findings to provide a polygenic risk score-guided precision medicine tool for statin treatment decisions.
Investigator: Iribarren, Carlos
Funder: National Heart, Lung, and Blood Institute

Genetic and Environmental Factors in Hyperlipidemia and Its Treatment

Study has 3 aims: Identify and characterize common and rare genetic variants and environmental factors underlying untreated LDL-cholesterol, HDL-cholesterol, triglycerides and total cholesterol in each of four race/ethnicity groups; identify common and rare genetic variants and environmental factors underlying response to statin and fibrate treatment of lipidemia; and characterize gene-environment interactions underlying plasma lipoprotein concentrations and their treatment.
Investigator: Iribarren, Carlos
Funder: University of California, San Francisco, Project Grant

Optimization of statin regimens for atherosclerotic cardiovascular disease prevention using polygenic risk scores and real-world evidence

This study will use the GERA cohort to develop a polygenic risk score-guided precision medicine tool for statin treatment decisions. It will develop an algorithm that predicts baseline atherosclerotic cardiovascular disease (ASCVD) and statin-induced ASCVD relative risk reduction incorporating ASCVD polygenic risk score on top of traditional ASCVD risk prediction tools.
Investigator: Iribarren, Carlos
Funder: National Heart, Lung, and Blood Institute

Polygenic Risk Scores for Advancing CVD Risk Stratification among Asymptomatic Adults

Leveraging the GERA Cohort to evaluate the performance of a 12-SNP PRS for CVD against the Pool Cohorts Equation across ethnic groups; validate MEGASTROKE Consortium PRS_32 for ischemic stroke; and assess the interplay between genetic background and lifestyle factors. We will evaluate the independent and joint contributions of PRS_12, smoking status, Mediterranean diet pattern and meeting physical activity recommendations to risk of CVD. Separate analyses for each ethnic group.
Investigator: Iribarren, Carlos
Funder: GENinCode PLC

Community-based, Longitudinal Cohort of Patients with Interstitial Lung Disease (ILD) in the Kaiser Permanente Northern California (KPNC) Health System

The KPNC-ILD cohort will consist of approximately 10,000 patients with interstitial lung disease. It will be built through electronic health recordbased case identification using an algorithm that will be further developed. We anticipate optimizing the existing KPNC-ILD algorithm and having a fully operational case identification process. The KPNC-ILD algorithm will be useful to clinical researchers worldwide who are interested in using large electronic health recordbased datasets to identify ILD cohorts.
Investigator: Iribarren, Carlos
Funder: Genentech, Inc.

Community-Based, Longitudinal cohort of Patients with Interstitial Lung Disease in the Kaiser Permanente Northern California Health System

The study aim is to optimize the Kaiser Permanente Northern California (KPNC) Interstitial Lung Disease (ILD) algorithm and establish the KPNC-ILD cohort. The KPNC-ILD cohort will consist of approximately 10,000 patients with ILD. It will be built through electronic health record-based case identification using an algorithm. We will optimize the existing algorithm and have a fully operational case identification process to build the cohort. The algorithm will be useful to clinical researchers worldwide who are interested in using large, electronic health record-based datasets to identify ILD cohorts.
Investigator: Iribarren, Carlos
Funder: Genentech, Inc.

MINERVA Biomarkers Substudy

We will conduct assays of a selected panel of cardiac, metabolic, and cancer biomarkers in 3,000 blood samples collected by the MINERVA (MultIethNic Study of BrEast ARterial Calcium Gradation and CardioVAscular Disease) Study and stored at the Kaiser Biobank. The biomarker data will be merged with the study datasets to perform association analyses with risk factors and outcomes. The proposed biomarker panel incudes Cystatin C, apolipoprotein A1, apolipoprotein B, Lp(a), BNP, Gamma prime fibrinogen, SuPAR, Galectin-3, hs-troponin, and a cancer biomarker panel.
Investigator: Iribarren, Carlos
Funder: Abbott Laboratories

Population-Based Pharmacogenomic Assessment of QT Prolongation

Cardiotoxicity of commonly prescribed medications, typically assessed by electrocardiographic features such as prolongation of the QT interval, has regulatory effects and is associated with potentially fatal outcomes. This project aims to advance understanding of the genetic basis for drug cardiotoxicity and its downstream consequences by leveraging the extensive data resources of the Kaiser Permanente Northern California Research Program on Genes, Environment and Health (RPGEH), and the ability to link these data to other health plan databases, namely Kaiser Permanente Northern California’s pharmacy, electrocardiogram, and outpatient/inpatient utilization databases. Longitudinal analyses of the QT interval over up to 20 years will be conducted in the large and ethnically diverse Genetic Epidemiology Research in Adult Health and Aging (GERA) cohort of the RPGEH. Genetic loci that influence adverse drug reactions will be identified and characterized, and the associated biological pathways and tissues will be investigated. This study will also examine: a) genetic predictors of adverse outcomes (e.g., ventricular arrhythmias and Torsade de Pointes), b) whether the identified gene-by-drug interactions are associated with these adverse outcomes, and c) degree of mediation by QTc prolongation.
Investigator: Iribarren, Carlos
Funder: National Heart, Lung, and Blood Institute

Multiethnic Study of Breast Arterial Calcium Gradation and CVD

Specific study aims are: 1) To establish a multi-ethnic cohort between the ages of 60 and 79 years with equal representation of white, African-American, Asian and Hispanic/Latina women. All participants will be recruited at the time of their regular screening mammography and will be free of clinical CVD at baseline. A new, validated densitometry method will be used to estimate BAC mass (in milligrams) using digital mammograms; 2) To document race/ethnic variation in BAC mass and to examine associations of BAC mass with sociodemographic background, family history of CVD, traditional and novel CVD risk factors, reproductive health factors, psychosocial factors, selected mineral metabolism factors, selected medication use (statins and nitrogen-containing bisphosphonates), breast size and sleep-related factors; and 3) To elucidate the role of BAC mass in the prediction of coronary heart disease (CHD), cerebrovascular disease, heart failure, peripheral vascular disease and total CVD and to determine whether adding BAC mass to prediction models based on traditional risk factors improves classification of risk for total CVD and its components. Accomplishing these aims will provide novel insights into the utility of BAC mass as a screening tool to assess CVD risk.
Investigator: Iribarren, Carlos
Funder: National Heart, Lung, and Blood Institute

Genomics of Blood Pressure-induced Target Organ Damage

The study’s aims are to: 1) ascertain the genomic contribution of common genetic variants to blood pressure (BP) variation within and between multiple ethnic groups; 2) conduct Mendelian randomization experiments using all new and known BP-associated variants to investigate the interplay of genetic BP risk with hypertensive target organ damage including left ventricular hypertrophy, renal dysfunction, and clinical cardiovascular disease across ethnic groups; and 3) perform deep whole-genome sequencing in very extreme individuals for systolic blood pressure to uncover the entire spectrum of allele frequencies.
Investigator: Iribarren, Carlos
Funder: National Heart, Lung, and Blood Institute

Defining a Comprehensive Reference Profile of Circulating Human Extracellular RNA: A CARDIA Ancillary Study

Blood and other body fluids harbor abundant and stable extracellular RNAs (exRNA) which are increasingly recognized as novel potential biomarkers of disease. This study has the main objective of generating reference profiles of both short and long non-coding regulatory exRNA, including environmentally-derived exRNA, from 720 plasma samples collected at the 10-year CARDIA visit. These healthy subjects will be stratified as follows: 180 subjects in each of the following 4 groups: male Caucasian, female Caucasian, male African American, female African American.
Investigator: Iribarren, Carlos
Funder: National Heart, Lung, and Blood Institute

Pharmacogenomics of Statin Therapy

This study will recruit statin users with: 1) a major acute coronary event (n=150), 2) new onset type 2 diabetes (n=150), 3) statin-induced myopathy (n=150), and controls free of all 3 conditions (n=300). We will then conduct genetic, transcriptomic, proteomic and/or metabolic profiling studies to identify biomarkers of statin response and side effects. We will use prescription fills and ICD-9 codes to identify statin users who are current Kaiser members that meet one of the three conditions described above. For each condition, a frequency-matched control group will be formed. Recruited individuals will complete a self-reported survey and provide a blood sample from which an aliquot will be used to generate a lymphoblastoid cell line. A separate aliquot will be used to store frozen viable cells for the future creation of ips cells, and plasma and DNA will be stored.
Investigator: Iribarren, Carlos
Funder: National Institute of General Medical Sciences

Lung Function Decline and Disease Risk from Young Adulthood to Middle Age

This study will take advantage of longitudinal data collection in CARDIA to evaluate the association between lung function and risk of future lung disease and cardiovascular disease. The study will perform spirometry in all CARDIA participants at the year 30 examination, and test the hypothesis that individuals with accelerated decline in lung function are at risk for both pulmonary (COPD) and cardiovascular (hypertension, diastolic heart dysfunction, coronary artery disease, and heart failure) diseases.
Investigator: Iribarren, Carlos
Funder: National Heart, Lung, and Blood Institute

Highlighted Publications

Clinical Utility of Multi-marker Genetic Risk Scores for Prediction of Incident Coronary Heart Disease: A Cohort Study among over 51 Thousand Individuals of European Ancestry

Author(s): Iribarren C; Lu M; Jorgenson E; Martínez M; Lluis-Ganella C; Subirana I; Salas E; Elosua R

Circ Cardiovasc Genet. 2016 Dec;9(6):531-540. Epub 2016-10-25.

Current Position(s):

Section Affiliations:

Primary Research Interests:

Studies

Optimization of statin regimens for atherosclerotic cardiovascular disease prevention using polygenic risk scores and real-world evidence

Genetic and Environmental Factors in Hyperlipidemia and Its Treatment

Optimization of statin regimens for atherosclerotic cardiovascular disease prevention using polygenic risk scores and real-world evidence

Polygenic Risk Scores for Advancing CVD Risk Stratification among Asymptomatic Adults

Community-based, Longitudinal Cohort of Patients with Interstitial Lung Disease (ILD) in the Kaiser Permanente Northern California (KPNC) Health System

Community-Based, Longitudinal cohort of Patients with Interstitial Lung Disease in the Kaiser Permanente Northern California Health System

MINERVA Biomarkers Substudy

Population-Based Pharmacogenomic Assessment of QT Prolongation

Multiethnic Study of Breast Arterial Calcium Gradation and CVD

Genomics of Blood Pressure-induced Target Organ Damage

Defining a Comprehensive Reference Profile of Circulating Human Extracellular RNA: A CARDIA Ancillary Study

Pharmacogenomics of Statin Therapy

Lung Function Decline and Disease Risk from Young Adulthood to Middle Age

Highlighted Publications

Clinical Utility of Multi-marker Genetic Risk Scores for Prediction of Incident Coronary Heart Disease: A Cohort Study among over 51 Thousand Individuals of European Ancestry

High-sensitivity cardiac troponin I and incident coronary heart disease among asymptomatic older adults

Publications

Novel genetic variants associated with inhaled corticosteroid treatment response in older adults with asthma

Neighborhood attributes and cardiovascular disease risk in breast cancer survivors: The Pathways Study

Development of cardiometabolic risk factors following endocrine therapy in women with breast cancer

Breast arterial calcification is associated with incident atrial fibrillation among older but not younger post-menopausal women

Extracting patient-level data from the electronic health record: Expanding opportunities for health system research

Reply to M.S. Ewer et al

High-sensitivity troponin I is associated with cardiovascular outcomes but not with breast arterial calcification among postmenopausal women

A large genome-wide association study of QT interval length utilizing electronic health records

Polygenic risk score and statin relative risk reduction for primary prevention of myocardial infarction in a real-world population

Modest effect of statins on fasting glucose in a longitudinal electronic health record based cohort

Usage of long-acting muscarinic antagonists and biologics as add-on therapy for patients in the United States with moderate-to-severe asthma

Multiomics Analysis Identifies BIRC3 as a Novel Glucocorticoid Response-Associated Gene

Risk of heart failure with preserved versus reduced ejection fraction in women with breast cancer

Risk of Cardiometabolic Risk Factors in Women With and Without a History of Breast Cancer: The Pathways Heart Study

Risk of Cardiovascular Disease in Women With and Without Breast Cancer: The Pathways Heart Study

Genetic associations and architecture of asthma-chronic obstructive pulmonary disease overlap

Breast Arterial Calcification: a Novel Cardiovascular Risk Enhancer Among Postmenopausal Women

Pharmacogenetics of inhaled corticosteroids and exacerbation risk in adults with asthma

Torsade de pointes: A nested case-control study in an integrated healthcare delivery system

Undifferentiated Induced Pluripotent Stem Cells as a Genetic Model for Nonalcoholic Fatty Liver Disease

A Polygenic Risk Score for Asthma in a Large Racially Diverse Population

QT Interval Dynamics and Cardiovascular Outcomes: A Cohort Study in an Integrated Health Care Delivery System

Rates of Major Cardiovascular Events in Severe Asthma: US Real-World and Clinical Trial-Eligible Populations

Effect of SLCO1B1 T521C on Statin-related Myotoxicity with Use of Lovastatin and Atorvastatin

Breast Arterial Calcification Is Not Associated with Mild Cognitive Impairment or Incident All-Cause Dementia Among Postmenopausal Women: The MINERVA Study

Magnesium intake was inversely associated with hostility among American young adults

The impact of adjusting for baseline in pharmacogenomic genome-wide association studies of quantitative change

Impact of idiopathic pulmonary fibrosis on longitudinal healthcare utilization in a community-based cohort of patients

Occupation versus environmental factors in hypersensitivity pneumonitis: population attributable fraction

Analysis of putative cis-regulatory elements regulating blood pressure variation

Real-Life Patterns of Exacerbations While on Inhaled Corticosteroids and Long-Acting Beta Agonists for Asthma over 15 Years

Adult Life-Course Trajectories of Lung Function and the Development of Emphysema: The CARDIA Lung Study

No Association Between Bone Mineral Density and Breast Arterial Calcification Among Postmenopausal Women

The impact of adjusting for baseline in pharmacogenomic genome-wide association studies of quantitative change

Closing the Evidence Gap in Interstitial Lung Disease: The Promise of Real World Data

Evaluation of commonly used ectoderm markers in iPSC trilineage differentiation

Large-scale, multi-ethnic genome-wide association study identifies novel loci contributing to asthma susceptibility in adults

Inflammation and Endothelial Activation in Early Adulthood are Associated with Future Emphysema: The CARDIA Lung Study

Kidney function, proteinuria and breast arterial calcification in women without clinical cardiovascular disease: The MINERVA study

A functional splicing variant associated with decreased asthma risk abolishes the ability of gasdermin B (GSMDB) to induce epithelial cell pyroptosis

Association of Breast Arterial Calcification Presence and Gradation with the Ankle-Brachial Index among Postmenopausal Women

Characterization of Statin Low-Density Lipoprotein Cholesterol Dose-Response Using Electronic Health Records in a Large Population-Based Cohort

Seasonal patterns of Asthma medication fills among diverse populations of the United States

Respiratory Symptoms in Young Adults and Future Lung Disease: The CARDIA Lung Study

Weighted Multi-marker Genetic Risk Scores for Incident Coronary Heart Disease among Individuals of African, Latino and East-Asian Ancestry

A large electronic-health-record-based genome-wide study of serum lipids

Trends in health care utilization for asthma exacerbations among diverse populations with asthma in the United States

MultIethNic Study of BrEast ARterial Calcium Gradation and CardioVAscular Disease: cohort recruitment and baseline characteristics

Cohort Study of ECG Left Ventricular Hypertrophy Trajectories: Ethnic Disparities, Associations With Cardiovascular Outcomes, and Clinical Utility

Code-Based Diagnostic Algorithms for Idiopathic Pulmonary Fibrosis: Case Validation and Improvement

Cardiovascular and cerebrovascular events among patients receiving omalizumab: Results from EXCELS, a prospective cohort study of moderate-to-severe asthma

Cardiovascular and cerebrovascular events among patients receiving omalizumab: Pooled analysis of patient-level data from 25 randomized, double-blind, placebo-controlled clinical trials

Detecting Cardiovascular Disease from Mammograms With Deep Learning

Television viewing and hostile personality trait increase the risk of injuries

Genome-wide association analyses using electronic health records identify new loci influencing blood pressure variation

Clinical Utility of Multi-marker Genetic Risk Scores for Prediction of Incident Coronary Heart Disease: A Cohort Study among over 51 Thousand Individuals of European Ancestry

No Association of Coronary Artery Disease with X-Chromosomal Variants in Comprehensive International Meta-Analysis

The genetics of blood pressure regulation and its target organs from association studies in 342,415 individuals

High-sensitivity cardiac troponin I and incident coronary heart disease among asymptomatic older adults