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Roy H, Bhardwaj S, Yla-Herttuala S. Molecular genetics of atherosclerosis. Hum Genet 2009; 125:467-91. [DOI: 10.1007/s00439-009-0654-5] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2008] [Accepted: 03/04/2009] [Indexed: 12/17/2022]
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Borissoff JI, Spronk HMH, Heeneman S, ten Cate H. Is thrombin a key player in the 'coagulation-atherogenesis' maze? Cardiovasc Res 2009; 82:392-403. [PMID: 19228706 DOI: 10.1093/cvr/cvp066] [Citation(s) in RCA: 160] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
In addition to its established roles in the haemostatic system, thrombin is an intriguing coagulation protease demonstrating an array of effects on endothelial cells, vascular smooth muscle cells (VSMC), monocytes, and platelets, all of which are involved in the pathophysiology of atherosclerosis. There is mounting evidence that thrombin acts as a powerful modulator of many processes like regulation of vascular tone, permeability, migration and proliferation of VSMC, recruitment of monocytes into the atherosclerotic lesions, induction of diverse pro-inflammatory markers, and all of these are related to the progression of cardiovascular disease. Recent studies in transgenic mice models indicate that the deletion of the natural thrombin inhibitor heparin cofactor II promotes an accelerated atherogenic state. Moreover, the reduction of thrombin activity levels in apolipoprotein E-deficient mice, because of the administration of the direct thrombin inhibitor melagatran, attenuates plaque progression and promotes stability in advanced atherosclerotic lesions. The combined evidence points to thrombin as a pivotal contributor to vascular pathophysiology. Considering the clinical development of selective anticoagulants including direct thrombin inhibitors, it is a relevant moment to review the different thrombin-induced mechanisms that contribute to the initiation, formation, progression, and destabilization of atherosclerotic plaques.
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Affiliation(s)
- Julian Ilcheff Borissoff
- Laboratory for Clinical Thrombosis and Hemostasis, Department of Internal Medicine, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center+ (MUMC+), Maastricht, The Netherlands
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203
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Guimarães AHC, de Bruijne ELE, Lisman T, Dippel DWJ, Deckers JW, Poldermans D, Rijken DC, Leebeek FWG. Hypofibrinolysis is a risk factor for arterial thrombosis at young age. Br J Haematol 2009; 145:115-20. [PMID: 19183334 DOI: 10.1111/j.1365-2141.2008.07568.x] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The relationship between defective fibrinolysis and arterial thrombosis is uncertain. The evaluation of the plasma fibrinolytic potential might provide stronger evidence linking fibrinolysis to arterial thrombosis than the evaluation of the individual fibrinolytic factors. We determined the plasma fibrinolytic potential of 335 young survivors of a first arterial thrombosis, including coronary artery disease (n = 198), ischaemic stroke (n = 103) and peripheral artery disease (n = 34), enrolled in a population-based case-control study and of 330 healthy individuals. Patients had significantly higher clot lysis times (CLTs) than the controls. Odds ratios (ORs) were calculated as a measure of relative risk. The OR for arterial thrombosis was determined in these subjects who had a CLT above the 60th, 70th, 80th, 90th and 95th percentiles of the values found in the control subjects. We found a progressive increase in risk of arterial thrombosis in subjects with hypofibrinolysis (OR: 1.7, 2.0, 2.3, 2.3 and 2.9, respectively). Relative risk estimates obtained in the whole group were comparable those obtained in the event-subgroups. In conclusion, a low plasma fibrinolytic potential, found in 10% of the population, increases the relative risk of arterial thrombosis twofold. This points to an important contribution of hypofibrinolysis to the burden of arterial thrombosis.
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Affiliation(s)
- Ana H C Guimarães
- Department of Haematology, Erasmus University Medical Centre, Rotterdam, The Netherlands
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204
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Affiliation(s)
- Keyue Ding
- From the Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minn
| | - Iftikhar J. Kullo
- From the Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minn
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205
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Meltzer ME, Doggen CJM, de Groot PG, Rosendaal FR, Lisman T. Reduced plasma fibrinolytic capacity as a potential risk factor for a first myocardial infarction in young men. Br J Haematol 2009; 145:121-7. [PMID: 19170679 DOI: 10.1111/j.1365-2141.2008.07569.x] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Studies on the relationship between fibrinolysis and arterial thrombosis have been conflicting. Previously, we demonstrated that hypofibrinolysis, as measured by a plasma-based assay, increased the risk of venous thrombosis. The present study investigated increased clot lysis time (CLT) measured with the same assay as a risk factor for myocardial infarction in a case-control study including 421 men with a first myocardial infarction and 642 controls below 70 years. CLT was strongly associated with body-mass index, lipid levels, blood pressure and C-reactive protein. Overall, risk of myocardial infarction was 1.4-fold (95% confidence interval (CI) 1.0-1.9) increased for CLT in the fourth quartile (longest CLT) compared with the first quartile. After adjusting for cardiovascular risk factors this risk disappeared (OR 1.0, 95%CI 0.6-1.5). In men aged <50 years the association was pronounced (OR 3.2, 95%CI 1.5-6.7). After adjustment for cardiovascular risk factors the risk was nearly twofold increased (OR 1.8, 95%CI 0.7-4.8). In men aged > or = 50 years, no clear association between CLT and risk of myocardial infarction was found. Our study suggests that hypofibrinolysis increases the risk of a first myocardial infarction in young men, although the causality of this association remains to be determined.
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Affiliation(s)
- Mirjam E Meltzer
- Department of Clinical Chemistry and Haematology, University Medical Centre, Utrecht, The Netherlands
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206
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Chen Y, Shen H, Yang F, Liu PY, Tang N, Recker RR, Deng HW. Choice of study phenotype in osteoporosis genetic research. J Bone Miner Metab 2009; 27:121-6. [PMID: 19184673 DOI: 10.1007/s00774-008-0020-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2007] [Accepted: 04/20/2008] [Indexed: 01/23/2023]
Abstract
Osteoporosis is a common disease characterized by compromised bone strength predisposing a person to an increased risk of osteoporotic fracture (OF). Recently, extensive efforts have been made to identify candidate genes underlying osteoporosis by the use of surrogate phenotypes, such as bone mineral density (BMD) and bone geometry. Among them, BMD is a suitable choice if we aim to classify the role of biological pathways for bone strength and to understand the bone conditions in the development of osteoporosis. However, evidences show that the genetic correlation between BMD and OF is very limited. In this review, we are mainly concerned with an important issue, i.e., phenotype choice in osteoporosis genetic research. For clarity, we address this issue with several arguments, and comments are made on most representative literature.
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Affiliation(s)
- Yuan Chen
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education and Institute of Molecular Genetics, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, Shannxi 710049, China
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207
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Lee SH, Shin DJ, Jang Y. Personalized Medicine in Coronary Artery Disease: Insights From Genomic Research. Korean Circ J 2009; 39:129-37. [PMID: 19949601 PMCID: PMC2771813 DOI: 10.4070/kcj.2009.39.4.129] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Prior clinical studies have demonstrated that a family history of coronary artery disease (CAD) is associated with future cardiovascular events. Although there are several Mendelian disorders that are associated with CAD, most common forms of CAD are believed to be multifactorial and the result of many genes with small individual effects. The identification of these genes and their variation would be very helpful for the prediction, prevention, and management of CAD; linkage analysis or candidate gene case-control studies have been largely unsuccessful. On the contrary, recent advances in genomic techniques have generated a large amount of deoxyribonucleic acid (DNA)-based information. The link between CAD and inflammation and biological pathways has been highlighted. In particular, several genome-wide association studies have replicated a novel gene marker on chromosome 9p21. The information gained from genomic studies, in combination with clinical data, is expected to refine personalized approaches to assess risk and guide management for CAD. Genetic risk scores derived from several functional single nucleotide polymorphisms (SNPs) or haplotypes in multiple genes may improve the prediction of CAD. Despite the complexity of CAD genetics, steady progress is expected.
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Affiliation(s)
- Sang-Hak Lee
- Cardiology Division, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
- Cardiovascular Genome Center, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Dong-Jik Shin
- Cardiovascular Genome Center, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Yangsoo Jang
- Cardiology Division, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
- Cardiovascular Genome Center, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
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208
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209
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de Gaetano G, Crescente M, Cerletti C. Current concepts about inhibition of platelet aggregation. Platelets 2008; 19:565-70. [PMID: 19012174 DOI: 10.1080/09537100802485947] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
One hundred twenty-seven years after Professor Giulio Bizzozero described the blood particle that has come to be known as the platelet, antiplatelet therapy has revolutionized the treatment of cardiovascular disease. Platelet function testing, introduced in 1962 with the advent of Born's aggregometer, heralded a renaissance in platelet research and provided a platelet function test to study platelet reactivity in vitro to help the diagnosis of bleeding disorders. More devices to test platelet function have emerged since, and these are now being applied mainly to assess antiplatelet drug efficacy in thrombotic disorders. Although this may be a logical use for platelet function tests, the data are replete with contradictions, and there is a lack of both consensus and standardization of the methodology. As a result, the clinical validity of platelet function results to monitor response to antiplatelet drugs has yet to be established.
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Affiliation(s)
- Giovanni de Gaetano
- Research Laboratories, Centre for High Technology Research and Education in Biomedical Sciences, Catholic University, Campobasso, Italy.
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210
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Affiliation(s)
- Mark Y Chan
- Duke Clinical Research Institute, Durham, NC 27705, USA
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211
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Bagos PG. Plasminogen activator inhibitor-1 4G/5G and 5,10-methylene-tetrahydrofolate reductase C677T polymorphisms in polycystic ovary syndrome. Mol Hum Reprod 2008; 15:19-26. [DOI: 10.1093/molehr/gan072] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
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212
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Correlation between the potency of a beta2-glycoprotein I-dependent lupus anticoagulant and the level of resistance to activated protein C. Blood Coagul Fibrinolysis 2008; 19:757-64. [DOI: 10.1097/mbc.0b013e32830f1b85] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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213
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Franchini M, Mannucci PM. Venous and arterial thrombosis: different sides of the same coin? Eur J Intern Med 2008; 19:476-81. [PMID: 19013373 DOI: 10.1016/j.ejim.2007.10.019] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2007] [Accepted: 10/01/2007] [Indexed: 01/10/2023]
Abstract
Until recently venous and arterial thrombosis were considered mechanistically distinct entities. However, their separate nature has been challenged by several studies showing that these conditions share a number of risk factors such as age, obesity, infections and the metabolic syndrome. The existence of an association is further supported by the finding that patients with venous thromboembolism are at higher risk of arterial events and vice versa. This review article addresses the association between venous and arterial thrombosis and its clinical and therapeutic implications. We conclude that arterial and venous thrombosis are mechanistically different, but that common risk factors are more relevant and frequent than previously thought.
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214
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Mahmoodi BK, Brouwer JLP, Veeger NJ, van der Meer J. Hereditary Deficiency of Protein C or Protein S Confers Increased Risk of Arterial Thromboembolic Events at a Young Age. Circulation 2008; 118:1659-67. [DOI: 10.1161/circulationaha.108.780759] [Citation(s) in RCA: 89] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
- Bakhtawar K. Mahmoodi
- From the Division of Hemostasis, Thrombosis and Rheology, Department of Hematology (B.K.M., J.-L.P.B., N.J.G.M.V., J.v.d.M.), and Trial Coordination Center, Department of Epidemiology (N.J.G.M.V.), University Medical Center Groningen, Groningen, the Netherlands
| | - Jan-Leendert P. Brouwer
- From the Division of Hemostasis, Thrombosis and Rheology, Department of Hematology (B.K.M., J.-L.P.B., N.J.G.M.V., J.v.d.M.), and Trial Coordination Center, Department of Epidemiology (N.J.G.M.V.), University Medical Center Groningen, Groningen, the Netherlands
| | - Nic J.G.M. Veeger
- From the Division of Hemostasis, Thrombosis and Rheology, Department of Hematology (B.K.M., J.-L.P.B., N.J.G.M.V., J.v.d.M.), and Trial Coordination Center, Department of Epidemiology (N.J.G.M.V.), University Medical Center Groningen, Groningen, the Netherlands
| | - Jan van der Meer
- From the Division of Hemostasis, Thrombosis and Rheology, Department of Hematology (B.K.M., J.-L.P.B., N.J.G.M.V., J.v.d.M.), and Trial Coordination Center, Department of Epidemiology (N.J.G.M.V.), University Medical Center Groningen, Groningen, the Netherlands
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215
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Pruissen DMO, Rosendaal FR, Frijns CJM, Kappelle LJ, Vos HL, Algra A. Prothrombotic gene variation and new vascular events after cerebral ischemia of arterial origin. J Thromb Haemost 2008; 6:1639-44. [PMID: 18662262 DOI: 10.1111/j.1538-7836.2008.03097.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Several genetic variants involved in hemostasis have been associated with ischemic stroke or myocardial infarction (MI). Stroke patients who carry a prothrombotic genotype may also be at increased risk for subsequent vascular events. PATIENTS AND METHODS We included 887 patients with non-disabling cerebral ischemia of arterial origin, who were referred to the University Medical Center Utrecht in the Netherlands between 1995 and 2005 and followed them for the occurrence of ischemic stroke, MI or death. The primary outcome was a composite of death from all vascular causes, non-fatal ischemic stroke, non-fatal MI, whichever happened first. We selected 22 prothrombotic variants in 14 genes that were previously associated with ischemic stroke or MI or had evidence of functionality. RESULTS During a 4.6-year mean follow-up period new vascular events occurred in 135 patients (annual event rate 3.3%). None of the 22 variants was associated with the occurrence of new vascular events. Eight additional analyses with secondary outcomes or among subgroups revealed four associations that were likely to be false positive after accounting for multiple testing. CONCLUSIONS In this cohort, prothrombotic genetic variants do not affect the risk of new vascular events after cerebral ischemia of arterial origin. This study does not support the use of prothrombotic genetic variants to identify stroke patients at increased risk for new vascular events or to guide antithrombotic treatment.
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Affiliation(s)
- D M O Pruissen
- Department of Neurology, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Utrecht, The Netherlands
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216
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A case report of myocardial infarction in young patient with a parental history of premature cardiovascular death: Combination of prothrombotic gene mutations. Int J Cardiol 2008; 130:e17-9. [DOI: 10.1016/j.ijcard.2007.07.042] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2007] [Accepted: 07/01/2007] [Indexed: 11/20/2022]
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217
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Pruissen DMO, Kappelle LJ, Rosendaal FR, Algra A. Prothrombotic genetic variants and atherosclerosis in patients with cerebral ischemia of arterial origin. Atherosclerosis 2008; 204:191-5. [PMID: 18848323 DOI: 10.1016/j.atherosclerosis.2008.08.033] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2007] [Revised: 08/13/2008] [Accepted: 08/28/2008] [Indexed: 01/29/2023]
Abstract
OBJECTIVE Prothrombotic genetic variants associated with arterial disease probably affect arterial thrombus formation but may also promote atherosclerosis. We hypothesized that specific prothrombotic variants lead to advanced atherosclerosis in patients with cerebral ischemia of arterial origin. METHODS AND RESULTS We included 689 patients with nondisabling cerebral ischemia of arterial origin. Twenty-two variants in 14 genes were genotyped. None of the variants was associated with carotid intima-media thickness or younger age at the occurrence of cerebral ischemia. Factor V Leiden (mean prevalence difference 25%; 95% CI 11-40) and the glycoprotein 1b-alpha Thr145Met variant (mean prevalence difference 12%; 95% CI 2.3-22) were associated with symptomatic carotid stenosis. After accounting for multiple testing by determination of the false discovery rate, only the association between factor V Leiden and symptomatic carotid stenosis remained present. CONCLUSIONS Prothrombotic genetic variants showed no consistent association with three markers of advanced atherosclerosis in patients with cerebral ischemia of arterial origin. This study does not support the hypothesis that prothrombotic genetic variants have a direct role in the pathogenesis of atherosclerosis.
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Affiliation(s)
- D M O Pruissen
- Department of Neurology, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Utrecht, The Netherlands
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218
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Ioannidis JPA. Effect of formal statistical significance on the credibility of observational associations. Am J Epidemiol 2008; 168:374-83; discussion 384-90. [PMID: 18611956 DOI: 10.1093/aje/kwn156] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
The author evaluated the implications of nominal statistical significance for changing the credibility of null versus alternative hypotheses across a large number of observational associations for which formal statistical significance (p < 0.05) was claimed. Calculation of the Bayes factor (B) under different assumptions was performed on 272 observational associations published in 2004-2005 and a data set of 50 meta-analyses on gene-disease associations (752 studies) for which statistically significant associations had been claimed (p < 0.05). Depending on the formulation of the prior, statistically significant results offered less than strong support to the credibility (B > 0.10) for 54-77% of the 272 epidemiologic associations for diverse risk factors and 44-70% of the 50 associations from genetic meta-analyses. Sometimes nominally statistically significant results even decreased the credibility of the probed association in comparison with what was thought before the study was conducted. Five of six meta-analyses with less than substantial support (B > 0.032) lost their nominal statistical significance in a subsequent (more recent) meta-analysis, while this did not occur in any of seven meta-analyses with decisive support (B < 0.01). In these large data sets of observational associations, formal statistical significance alone failed to increase much the credibility of many postulated associations. Bayes factors may be used routinely to interpret "significant" associations.
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Affiliation(s)
- John P A Ioannidis
- Clinical and Molecular Epidemiology Unit, Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece.
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219
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Di Micco P, Di Fiore R, Niglio A, Quaranta S, Angiolillo A, Cardillo G, Castaldo G. Different outcome of six homozygotes for prothrombin A20210A gene variant. J Transl Med 2008; 6:36. [PMID: 18627609 PMCID: PMC2483266 DOI: 10.1186/1479-5876-6-36] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2008] [Accepted: 07/15/2008] [Indexed: 11/10/2022] Open
Abstract
Prothrombin G20210A gene variant (FII G20210A) is a risk factor for venous thrombotic disease while conflicting results have been reported for the risk of arterial thrombotic events. However, vascular episodes were absent in up to 40% of the 67 homozygotes for the G20210A described so far, which indicates that the clinical expression depends on additional risk/trigger factors. We describe six homozygotes for the G20210A variant, among which the first pair of siblings (cases n. 3 and 4) reported so far that displayed a strongly heterogeneous clinical outcome. Case 1, a female of 27 years, developed a full thrombosis of common femoral, superficial and popliteal veins. She assumed oral contraceptives in the last two years. Case n. 2, 34 years old, suffered of recurrent pregnancy loss in absence of any causative alteration. Cases n. 3 and n. 5 experienced arterial thrombotic disease, i.e., juvenile myocardial infarction (40 years old) and stroke (48 years old), respectively, in absence of other risk factors. Finally, cases n. 4 and 6 identified as homozygotes for the FII G20210A variant being consanguineous of symptomatic subjects bearing the variant, did not experience any episode of venous nor arterial disease. Both of them have chronic liver disease with an impairement of the prothrombin time INR. Thus, homozygotes for the G20210A are at risk for arterial (in addition to venous) thromobotic events; chronic liver disease might modulate this risk.
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Affiliation(s)
- Pierpaolo Di Micco
- Department of Internal Medicine, Fatebenefratelli Hospital of Naples, Naples, Italy.
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220
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Franchini M, Peyvandi F, Mannucci PM. The Genetic Basis of Coronary Artery Disease: From Candidate Genes to Whole Genome Analysis. Trends Cardiovasc Med 2008; 18:157-62. [DOI: 10.1016/j.tcm.2008.04.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2008] [Revised: 04/15/2008] [Accepted: 04/17/2008] [Indexed: 12/22/2022]
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221
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Saely CH, Muendlein A, Vonbank A, Sonderegger G, Aczel S, Rein P, Risch L, Drexel H. Type 2 diabetes significantly modulates the cardiovascular risk conferred by the PAI-1 -675 4G/5G polymorphism in angiographied coronary patients. Clin Chim Acta 2008; 396:18-22. [PMID: 18619429 DOI: 10.1016/j.cca.2008.06.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2008] [Revised: 06/13/2008] [Accepted: 06/13/2008] [Indexed: 11/16/2022]
Abstract
BACKGROUND The association of the -675 4G/5G polymorphism of the plasminogen activator inhibitor-1 (PAI-1) gene with cardiovascular disease in patients with type 2 diabetes (T2DM) is unknown. METHODS Genotyping was performed in 672 consecutive Caucasian patients undergoing coronary angiography for the evaluation of stable coronary artery disease (CAD). Vascular events were recorded over 4 years. RESULTS In non-diabetic subjects (n=524), the homozygous PAI-1 4G4G genotype was significantly associated with significant coronary stenoses>or=50% (adjusted odds ratio (OR) OR=1.84 [1.17-2.92]; p=0.009); however, in T2DM patients (n=148) no such association was observed (OR=0.67 [0.26-1.71]; p=0.401). An interaction term T2DMx4G4G genotype was significant (p=0.006), indicating a significantly stronger association of the polymorphism with CAD in non-diabetic subjects than in patients with T2DM. Also prospectively, the 4G4G genotype conferred an increased risk of vascular events in non-diabetic subjects but not in T2DM patients (hazard ratios 1.76 [1.13-2.74]; p=0.014 and 0.68 [0.30-1.54]; p=0.360, respectively). Again, the interaction T2DMx4G4G genotype was significant (p=0.018). CONCLUSIONS Presence of T2DM significantly modulates the vascular risk conferred by the PAI-1 -675 4G/5G polymorphism in angiographied coronary patients.
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Affiliation(s)
- Christoph H Saely
- Vorarlberg Institute for Vascular Investigation and Treatment (VIVIT), Feldkirch, Austria
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222
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Settin A, Dowaidar M, El-Baz R, Abd-Al-Samad A, El-Sayed I, Nasr M. Frequency of factor V Leiden mutation in Egyptian cases with myocardial infarction. Hematology 2008; 13:170-174. [DOI: 10.1179/102453308x316158] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/29/2023] Open
Affiliation(s)
- Ahmad Settin
- Genetic UnitGenetic Engineering & Biotechnology Research Institute, Menoufya University, Egypt
| | - Moataz Dowaidar
- Molecular Biology DepartmentGenetic Engineering & Biotechnology Research Institute, Menoufya University, Egypt
| | - Rizk El-Baz
- Genetic UnitGenetic Engineering & Biotechnology Research Institute, Menoufya University, Egypt
| | - Ayman Abd-Al-Samad
- Cardiology DepartmentInternal Medicine University Hospital, Mansoura, Egypt
| | - Ibrahim El-Sayed
- Cardiology DepartmentInternal Medicine University Hospital, Mansoura, Egypt
| | - Mahmoud Nasr
- Molecular Biology DepartmentGenetic Engineering & Biotechnology Research Institute, Menoufya University, Egypt
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223
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van der Krabben MD, Rosendaal FR, van der Bom JG, Doggen CJM. Polymorphisms in coagulation factors and the risk of recurrent cardiovascular events in men after a first myocardial infarction. J Thromb Haemost 2008; 6:720-5. [PMID: 18284606 DOI: 10.1111/j.1538-7836.2008.02930.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND The aim of this study was to examine whether genetic predisposition to high levels of coagulation factors influences the risk of developing fatal and non-fatal arterial cardiovascular events in men with a first myocardial infarction (MI). METHODS We performed a cohort study among 542 MI patients with a mean age of 56 years (range 32-70 years) at the time of the event. All of the men had a first MI between 1990 and 1996 and were followed until 1 September 2004. DNA was analyzed for polymorphisms of fibrinogen, prothrombin (factor II), factor V, factor VII and plasminogen activator inhibitor type 1, all of which are associated with gain of function of the protein. We collected information from hospital files and general practitioners on the occurrence of major arterial events. RESULTS In total, 254 major arterial cardiovascular events occurred during a median follow-up period of 11 years (range 0.2-15 years). The point estimates of the relative rates (RRs) of these events for the variant genotypes were all between 0.7 and 1.1 except for the prothrombin 20210A mutation: RR 1.8 (95% confidence interval 0.8-4.1). CONCLUSION These findings suggest that there is no association between coagulation factor polymorphisms, previously associated with plasma levels, and the risk of recurrent cardiovascular events.
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Affiliation(s)
- M D van der Krabben
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
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Lowe GDO. Coagulation, genotypes and recurrent cardiovascular events: what further studies are required? J Thromb Haemost 2008; 6:717-9. [PMID: 18318688 DOI: 10.1111/j.1538-7836.2008.02947.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- G D O Lowe
- Division of Cardiovascular and Medical Sciences, University of Glasgow, Royal Infirmary, Glasgow, UK.
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Salles II, Feys HB, Iserbyt BF, De Meyer SF, Vanhoorelbeke K, Deckmyn H. Inherited traits affecting platelet function. Blood Rev 2008; 22:155-72. [DOI: 10.1016/j.blre.2007.11.002] [Citation(s) in RCA: 87] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Humphries SE, Yiannakouris N, Talmud PJ. Cardiovascular disease risk prediction using genetic information (gene scores): is it really informative? Curr Opin Lipidol 2008; 19:128-32. [PMID: 18388692 DOI: 10.1097/mol.0b013e3282f5283e] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
PURPOSE OF REVIEW DNA-based tests for assessment of genetic predisposition to coronary heart disease need to provide information over and above that of conventional risk factors. The efficacy of selected 'candidate' gene loci in risk algorithms, to improve the predictive accuracy for coronary heart disease, remains to be demonstrated. RECENT FINDINGS Although many candidate genes for coronary heart disease have been tested, the optimal set of risk genotypes has yet to be identified. There is only a relatively modest risk to be expected in association with any single genotype, published estimates are in the range of 1.12-1.73. Thus the risk associated with any one genotype is modest, but, in combination, selected genotypes may be associated with a clinically significant risk. Since the allele frequency for many of these variants is high, many individuals will carry several 'risk alleles'. A small number of selected single nucleotide polymorphisms should complement the conventional risk factors to identify high-risk individuals in whom correction of 'modifiable risk factors' through lifestyle interventions or medication would be most beneficial. SUMMARY As our understanding of how genetic variation impacts on common diseases advances, the novel loci identified by genome-wide association scans associated with disease risk will rapidly improve these risk algorithms.
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Affiliation(s)
- Steve E Humphries
- Division of Cardiovascular Genetics, British Heart Foundation Laboratories, Department of Medicine, Royal Free and UCL Medical School, London, UK.
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Association of deoxyribonuclease I genetic polymorphisms with myocardial infarction in Han Chinese. Mol Biol Rep 2008; 36:595-601. [DOI: 10.1007/s11033-008-9218-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2007] [Accepted: 02/21/2008] [Indexed: 11/30/2022]
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Franchini M, Mannucci PM. The hemostatic balance revisited through the lessons of mankind evolution. Intern Emerg Med 2008; 3:3-8. [PMID: 18283529 DOI: 10.1007/s11739-008-0100-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2007] [Accepted: 07/06/2007] [Indexed: 11/24/2022]
Abstract
Under physiologic conditions, a hemostatic balance is achieved through the effects of natural procoagulant and anticoagulant factors which, in equilibrium with each other, provide hemostasis at the sites of vascular injury. Abnormalities of these hemostasis factors can result in a tendency toward hemorrhagic or thrombotic events. In this review the influence of inherited prothrombotic risk factors--especially the more frequent factor V Leiden and prothrombin gene mutations--on normal and abnormal hemostasis is analyzed from an evolutionary point of view. The effect of inherited bleeding disorders on the development of thrombotic or atherosclerotic processes is also discussed.
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Affiliation(s)
- Massimo Franchini
- Transfusion and Hemophilia Center, City Hospital of Verona, Piazzale Ludovico Scuro, 37134 Verona, Italy.
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Janssens ACJW, Gwinn M, Bradley LA, Oostra BA, van Duijn CM, Khoury MJ. A critical appraisal of the scientific basis of commercial genomic profiles used to assess health risks and personalize health interventions. Am J Hum Genet 2008; 82:593-9. [PMID: 18319070 PMCID: PMC2427295 DOI: 10.1016/j.ajhg.2007.12.020] [Citation(s) in RCA: 159] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2007] [Revised: 11/08/2007] [Accepted: 12/04/2007] [Indexed: 12/25/2022] Open
Abstract
Predictive genomic profiling used to produce personalized nutrition and other lifestyle health recommendations is currently offered directly to consumers. By examining previous meta-analyses and HuGE reviews, we assessed the scientific evidence supporting the purported gene-disease associations for genes included in genomic profiles offered online. We identified seven companies that offer predictive genomic profiling. We searched PubMed for meta-analyses and HuGE reviews of studies of gene-disease associations published from 2000 through June 2007 in which the genotypes of people with a disease were compared with those of a healthy or general-population control group. The seven companies tested at least 69 different polymorphisms in 56 genes. Of the 56 genes tested, 24 (43%) were not reviewed in meta-analyses. For the remaining 32 genes, we found 260 meta-analyses that examined 160 unique polymorphism-disease associations, of which only 60 (38%) were found to be statistically significant. Even the 60 significant associations, which involved 29 different polymorphisms and 28 different diseases, were generally modest, with synthetic odds ratios ranging from 0.54 to 0.88 for protective variants and from 1.04 to 3.2 for risk variants. Furthermore, genes in cardiogenomic profiles were more frequently associated with noncardiovascular diseases than with cardiovascular diseases, and though two of the five genes of the osteogenomic profiles did show significant associations with disease, the associations were not with bone diseases. There is insufficient scientific evidence to conclude that genomic profiles are useful in measuring genetic risk for common diseases or in developing personalized diet and lifestyle recommendations for disease prevention.
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Affiliation(s)
- A Cecile J W Janssens
- Department of Public Health, Erasmus MC University Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands.
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Martinelli N, Trabetti E, Pinotti M, Olivieri O, Sandri M, Friso S, Pizzolo F, Bozzini C, Caruso PP, Cavallari U, Cheng S, Pignatti PF, Bernardi F, Corrocher R, Girelli D. Combined effect of hemostatic gene polymorphisms and the risk of myocardial infarction in patients with advanced coronary atherosclerosis. PLoS One 2008; 3:e1523. [PMID: 18253477 PMCID: PMC2211406 DOI: 10.1371/journal.pone.0001523] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2007] [Accepted: 01/02/2008] [Indexed: 12/16/2022] Open
Abstract
Background Relative little attention has been devoted until now to the combined effects of gene polymorphisms of the hemostatic pathway as risk factors for Myocardial Infarction (MI), the main thrombotic complication of Coronary Artery Disease (CAD). The aim of this study was to evaluate the combined effect of ten common prothrombotic polymorphisms as a determinant of MI. Methodology/Principal Findings We studied a total of 804 subjects, 489 of whom with angiographically proven severe CAD, with or without MI (n = 307; n = 182; respectively). An additive model considering ten common polymorphisms [Prothrombin 20210G>A, PAI-1 4G/5G, Fibrinogen β -455G>A, FV Leiden and “R2”, FVII -402G>A and -323 del/ins, Platelet ADP Receptor P2Y12 -744T>C, Platelet Glycoproteins Ia (873G>A), and IIIa (1565T>C)] was tested. The prevalence of MI increased linearly with an increasing number of unfavorable alleles (χ2 for trend = 10.68; P = 0.001). In a multiple logistic regression model, the number of unfavorable alleles remained significantly associated with MI after adjustment for classical risk factors. As compared to subjects with 3-7 alleles, those with few (≤2) alleles had a decreased MI risk (OR 0.34, 95%CIs 0.13–0.93), while those with more (≥8) alleles had an increased MI risk (OR 2.49, 95%CIs 1.03–6.01). The number of procoagulant alleles correlated directly (r = 0.49, P = 0.006) with endogenous thrombin potential. Conclusions The combination of prothrombotic polymorphisms may help to predict MI in patients with advanced CAD.
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Affiliation(s)
- Nicola Martinelli
- Department of Clinical and Experimental Medicine, University of Verona, Verona, Italy
| | - Elisabetta Trabetti
- Section of Biology and Genetics, Department of Mother and Child and Biology–Genetics, University of Verona, Verona, Italy
| | - Mirko Pinotti
- Department of Biochemistry and Molecular Biology, University of Ferrara , Ferrara, Italy
| | - Oliviero Olivieri
- Department of Clinical and Experimental Medicine, University of Verona, Verona, Italy
| | - Marco Sandri
- Department of Clinical and Experimental Medicine, University of Verona, Verona, Italy
| | - Simonetta Friso
- Department of Clinical and Experimental Medicine, University of Verona, Verona, Italy
| | - Francesca Pizzolo
- Department of Clinical and Experimental Medicine, University of Verona, Verona, Italy
| | - Claudia Bozzini
- Department of Clinical and Experimental Medicine, University of Verona, Verona, Italy
| | - Pier Paolo Caruso
- Department of Biochemistry and Molecular Biology, University of Ferrara , Ferrara, Italy
| | - Ugo Cavallari
- Section of Biology and Genetics, Department of Mother and Child and Biology–Genetics, University of Verona, Verona, Italy
| | - Suzanne Cheng
- Department of Human Genetics, Roche Molecular Systems, Inc., Alameda, California, United States of America
| | - Pier Franco Pignatti
- Section of Biology and Genetics, Department of Mother and Child and Biology–Genetics, University of Verona, Verona, Italy
| | - Francesco Bernardi
- Department of Biochemistry and Molecular Biology, University of Ferrara , Ferrara, Italy
| | - Roberto Corrocher
- Department of Clinical and Experimental Medicine, University of Verona, Verona, Italy
| | - Domenico Girelli
- Department of Clinical and Experimental Medicine, University of Verona, Verona, Italy
- * To whom correspondence should be addressed. E-mail:
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Associations of von Willebrand factor, fibrin D-dimer and tissue plasminogen activator with incident coronary heart disease: British Women's Heart and Health cohort study. ACTA ACUST UNITED AC 2008; 14:638-45. [PMID: 17925622 DOI: 10.1097/hjr.0b013e3280e129d0] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Associations of three markers of thrombotic tendency, von Willebrand factor, tissue plasminogen activator antigen and fibrin D-dimer, with coronary heart disease have been reported in meta-analyses. It is not known, however, whether findings are generalizable to older women. DESIGN Prospective cohort of 3582 women aged 60-79 years randomly selected from 23 towns without evidence of cardiovascular disease at entry into the British Women's Heart and Health Study. METHODS Women were followed for 4.7 years for incident coronary heart disease. Cox proportional hazard models were used to compare the hazard ratio of coronary heart disease per doubling for each thrombotic factor. RESULTS In models adjusting for age and town only there was no association between von Willebrand factor or D-dimer and incidence of coronary heart disease, but there was a positive association of tissue plasminogen activator: coronary heart disease hazard ratio per doubling was 1.37 (95% confidence interval: 1.08-1.75). Adjustment for potential confounders (socio-economic position, smoking, lung function, physical activity, alcohol consumption, body mass index, waist-to-hip ratio) attenuated association to 1.20 (0.92-1.58). Further adjustment for risk factors that may be part of the same pathophysiological process linking tissue plasminogen activator to coronary heart disease (high density lipoprotein cholesterol, triglycerides, blood pressure, fasting glucose, insulin, C-reactive protein, fibrinogen) attenuated the hazard ratio to 1.05 (0.79-1.40). CONCLUSION In older women, tissue plasminogen activator was associated with incident coronary heart disease, but does not appear to be an independent risk factor for coronary heart disease as the association was attenuated by adjustment for confounding and other metabolic and vascular risk factors.
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Lowe GDO. Coagulation factors, activation markers and risk of coronary heart disease: the Northwick Park Heart Studies. J Thromb Haemost 2008; 6:256-8. [PMID: 18021300 DOI: 10.1111/j.1538-7836.2008.02842.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- G D O Lowe
- Division of Cardiovascular and Medical Sciences, University of Glasgow, Royal Infirmary, Glasgow, UK.
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LOWE GDO. Coagulation factors, activation markers and risk of coronary heart disease: the Northwick Park Heart Studies. J Thromb Haemost 2008; 6:256-8. [DOI: 10.1111/j.1538-7836.2007.02842.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Thrombophilic Variables Do Not Increase the Generation or Procoagulant Activity of Thrombin During Cardiopulmonary Bypass. Ann Thorac Surg 2008; 85:536-42. [DOI: 10.1016/j.athoracsur.2007.09.045] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2007] [Revised: 09/20/2007] [Accepted: 09/24/2007] [Indexed: 11/21/2022]
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Guías de práctica clínica sobre prevención de la enfermedad cardiovascular: versión resumida. Rev Esp Cardiol 2008. [DOI: 10.1157/13114961] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Smith NL, Bis JC, Biagiotti S, Rice K, Lumley T, Kooperberg C, Wiggins KL, Heckbert SR, Psaty BM. Variation in 24 hemostatic genes and associations with non-fatal myocardial infarction and ischemic stroke. J Thromb Haemost 2008; 6:45-53. [PMID: 17927806 DOI: 10.1111/j.1538-7836.2007.02795.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Arterial thrombosis involves platelet aggregation and clot formation, yet little is known about the contribution of genetic variation in fibrin-based hemostatic factors to arterial clotting risk. We hypothesized that common variation in 24 coagulation-fibrinolysis genes would contribute to risk of incident myocardial infarction (MI) or ischemic stroke (IS). METHODS We conducted a population-based, case-control study. Subjects were hypertensive adults and postmenopausal women 30-79 years of age, who sustained a first MI (n = 856) or IS (n = 368) between 1995 and 2002, and controls matched on age, hypertension status, and calendar year (n = 2,689). We investigated the risk of MI and IS associated with (i) global variation within each gene as measured by common haplotypes and (ii) individual haplotypes and single nucleotide polymorphisms (SNPs). Significance was assessed using a 0.2 threshold of the false discovery rate q-value, which accounts for multiple testing. RESULTS After accounting for multiple testing, global genetic variation in factor (F) VIII was associated with IS risk. Two haplotypes in FVIII and one in FXIIIa1 were significantly associated with increased IS risk (all q-values < 0.2). A plasminogen gene SNP was associated with MI risk. All are new discoveries not previously reported. Another 24 tests had P-values < 0.05 and q-values > 0.2 in MI and IS analyses, 23 of which are new and hypothesis generating. CONCLUSIONS Apart from the association of FVIII variation with IS, we found little evidence that common variation in the 24 candidate fibrin-based hemostasis genes strongly influences arterial thrombotic risk, but our results cannot rule out small effects.
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Affiliation(s)
- N L Smith
- Department of Epidemiology, University of Washington, Seattle, WA, USA.
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Brummel-Ziedins K, Undas A, Orfeo T, Gissel M, Butenas S, Zmudka K, Mann KG. Thrombin generation in acute coronary syndrome and stable coronary artery disease: dependence on plasma factor composition. J Thromb Haemost 2008; 6:104-10. [PMID: 17944993 DOI: 10.1111/j.1538-7836.2007.02799.x] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Acute coronary syndrome (ACS) is associated with thrombin formation, triggered by ruptured or eroded coronary atheroma. We investigated whether thrombin generation based on circulating coagulation protein levels, could distinguish between acute and stable coronary artery disease (CAD). METHODS AND RESULTS Plasma coagulation factor (F) compositions from 28 patients with ACS were obtained after onset of chest pain. Similar data were obtained from 25 age- and sex-matched patients with stable CAD. All individuals took aspirin. Patients on anticoagulant therapy were excluded. The groups were similar in demographic characteristics, comorbidities and concomitant treatment. Using each individual's coagulation protein composition, tissue factor (TF) initiated thrombin generation was assessed both computationally and empirically. TF pathway inhibitor (TFPI), antithrombin (AT), factor II (FII) and FVIII differed significantly (P < 0.01) between the groups, with levels of FII, FVIII and TFPI higher and AT lower in ACS patients. When thrombin generation profiles from individuals in each group were compared, simulated maximum thrombin levels (P < 0.01) and rates (P < 0.01) were 50% higher with ACS while the initiation phases of thrombin generation were shorter. Empirical reconstructions of the populations reproduced the thrombin generation profiles generated by the computational model. The differences between the thrombin generation profiles for each population were primarily dependent upon the collective contribution of AT, FII and FVIII. CONCLUSION Simulations of thrombin formation based on plasma composition can discriminate between acute and stable CAD.
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Tsantes AE, Nikolopoulos GK, Bagos PG, Tsiara CG, Kapsimali V, Travlou A, Vaiopoulos G. Plasminogen activator inhibitor-1 4G/5G polymorphism and risk of ischemic stroke: a meta-analysis. Blood Coagul Fibrinolysis 2007; 18:497-504. [PMID: 17581326 DOI: 10.1097/mbc.0b013e3281ec4eee] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This study investigated the hypothesis that the insertion/deletion (4G/5G) polymorphism of the plasminogen activator inhibitor type-1 gene affects the risk for ischemic stroke, since results concerning this association have been controversial. We therefore performed a meta-analysis of published data regarding this issue. A comprehensive electronic search was carried out until January 2006. The analysis was performed using random-effects models and meta-regression. Eighteen eligible studies were retrieved (15 case-control studies and three cohort studies). The case-control studies included 3104 cases and 4870 control individuals concerning the contrast of 4G/4G versus remaining genotypes. The 4G pooled allele frequencies in cases and controls were 54.21 and 54.75%, respectively. Overall, the per-allele odds ratio of the 4G allele was 0.98 (95% confidence interval, 0.858-1.121). Regarding genotypes, we derived nonsignificant odds ratios in all contrasts. The subanalysis including the three studies with a prospective design in the 4G/4G versus 5G/5G contrast derived a significant result (relative risk, 0.523; 95% confidence interval, 0.353-0.775), but the estimated effect size was insignificant when cohort and case-control studies were analyzed together (relative risk, 0.848; 95% confidence interval, 0.662-1.087). We failed to demonstrate a significant association between the 4G/5G polymorphism and ischemic stroke under basal conditions. Determination of plasminogen activator inhibitor type-1 function seems of much higher clinical value than determination of the 4G/5G polymorphism. The effect of this genotype on risk of ischemic stroke in acute stressful diseases and the role of cohort studies in genetic epidemiology, however, warrant further investigation.
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Affiliation(s)
- Argirios E Tsantes
- Laboratory of Hematology and Blood Bank Unit, 'Attikon' General Hospital, School of Medicine, University of Athens, Athens, Greece
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Ekström M, Silveira A, Bennermo M, Eriksson P, Tornvall P. Coagulation factor VII and inflammatory markers in patients with coronary heart disease. Blood Coagul Fibrinolysis 2007; 18:473-7. [PMID: 17581323 DOI: 10.1097/mbc.0b013e3281a3057f] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
To further elucidate the connection between inflammation and factor VII (FVII) taking genetic variation in the FVII locus into account, we have examined 387 patients after myocardial infarction and 387 age-matched and sex-matched healthy control individuals. Circulating levels of C-reactive protein, FVII antigen (FVIIag), activated FVII (FVIIa), fibrinogen and interleukin-6 were analysed and all subjects were genotyped for the Arg353Gln polymorphism in the FVII locus. Plasma concentrations of C-reactive protein, fibrinogen, and interleukin-6 were higher among patients than control individuals. FVIIag was lower in the patient group, but for FVIIa there was no difference between the two groups. Among the inflammatory markers, only C-reactive protein indicated a weak nonlinear association with FVII. No significant difference in frequency of the Gln allele was observed between patients and control individuals but the presence of the Gln allele was associated with lower plasma levels of FVIIag and FVIIa in both groups. The low-grade chronic inflammation seen 3 months after myocardial infarction is not of major importance for the variation in plasma concentration of FVII. The presence of the Gln allele in the Arg353Gln polymorphism in the FVII locus did not differ between patients and control individuals but was associated with lower plasma levels of FVIIag and FVIIa that could have a protective effect against myocardial infarction. To further elucidate these facts, a prospective study should be performed to reduce the risk of a possible selection bias due to coronary heart disease death seen in retrospective case-control studies.
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Affiliation(s)
- Mattias Ekström
- Department of Cardiology, Karolinska University Hospital Solna, Karolinska Institutet, Solna, Sweden.
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Corsetti JP, Ryan D, Moss AJ, Rainwater DL, Zareba W, Sparks CE. Plasminogen activator inhibitor-1 polymorphism (4G/5G) predicts recurrence in nonhyperlipidemic postinfarction patients. Arterioscler Thromb Vasc Biol 2007; 28:548-54. [PMID: 18096824 DOI: 10.1161/atvbaha.107.155556] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Nonhyperlipidemic postinfarction patients are at high risk for recurrent coronary events by virtue of incident myocardial infarction (MI); however, few studies assess risk beyond incident MI. The aim of this study was to assess such risk as a function of 37 atherosclerosis-associated genetic polymorphisms and 17 blood marker variables. METHODS AND RESULTS Screening of polymorphisms in nonhyperlipidemic postinfarction patients revealed significant risk only for the 4G/5G insertion/deletion polymorphism in the promoter of the plasminogen-activator inhibitor-1 (PAI-1) gene. Outcome event mapping, an exploratory data analysis tool, was then applied to define a subgroup (182 patients from total study population of 846 nondiabetic patients) exhibiting maximal functional dependence of risk on the PAI-1 polymorphism. Cox multivariable regression analyses within the subgroup adjusted for significant clinical covariates and medication use as a function of the PAI-1 polymorphism and 17 atherosclerosis-associated blood markers revealed significant risk for patients homozygous for the 4G allele (hazard ratio 4.30, 95% CI 1.98 to 9.33, P=0.00023), and lack of significant risk-association with any blood marker. CONCLUSIONS In a subgroup of normolipidemic postinfarction patients, only the PAI-1 4G/5G polymorphism was associated with recurrent risk from a set of atherosclerosis-associated genetic polymorphisms and blood markers.
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Affiliation(s)
- James P Corsetti
- Department of Pathology and Laboratory Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642, USA.
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Lieb W, Mayer B, König IR, Borwitzky I, Götz A, Kain S, Hengstenberg C, Linsel-Nitschke P, Fischer M, Döring A, Wichmann HE, Meitinger T, Kreutz R, Ziegler A, Schunkert H, Erdmann J. Lack of association between the MEF2A gene and myocardial infarction. Circulation 2007; 117:185-91. [PMID: 18086930 DOI: 10.1161/circulationaha.107.728485] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Coronary artery disease (CAD) and myocardial infarction (MI) are caused in part by genetic factors. Recently, the MEF2A gene was linked to MI/CAD in a single pedigree with autosomal-dominant pattern of inheritance. In addition, genetic variants within the gene have been associated with MI in case-control settings, producing inconsistent results. METHODS AND RESULTS The MEF2A gene was sequenced in MI patients from 23 MI families (> or =5 affected members per family), but no mutation was identified in any of these extended families. Moreover, the Pro279Leu variant in exon 7 was analyzed in 1181 unrelated MI patients with a positive family history for MI/CAD, in 533 patients with sporadic MI, and in 2 control populations (n=1021 and n=1055), showing no evidence for association with MI/CAD. In addition, a (CAG)n repeat in exon 11 was genotyped in 543 sporadic MI patients and in 1190 controls without evidence for association with MI. Finally, analyzing 11 single-nucleotide polymorphisms from the GeneChip Mapping 500K Array, genotyped in 1644 controls and 753 cases, failed to provide evidence for association (region-wide P=0.23). CONCLUSIONS Studying independent samples of >1700 MI patients, 2 large control populations, and multiple families with apparently mendelian inheritance of the disease, we found no evidence for any linkage or association signal in the MEF2A gene.
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Affiliation(s)
- Wolfgang Lieb
- Medizinische Klinik II, Universität zu Lübeck, Lübeck, Germany
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Muetze S, Eggermann T, Leeners B, Birke C, Kuse S, Ortlepp JR, Rudnik-Schoeneborn S, Zerres K, Rath W. The 4G/5G polymorphism in the plasminogen activator inhibitor-1 gene is not associated with HELLP syndrome. J Thromb Thrombolysis 2007; 27:141-5. [PMID: 18058192 DOI: 10.1007/s11239-007-0175-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2007] [Accepted: 11/20/2007] [Indexed: 12/20/2022]
Abstract
Plasminogen activator inhibitor-1 (PAI-1) is a major inhibitor of fibrinolysis, and a single nucleotide insertion/deletion (4G/5G) polymorphism in the promoter region of the PAI-1 gene has been identified. Subjects homozygous for the 4G allele have the highest PAI-levels due to increased PAI-1 gene transcription. Pre-eclampsia, and one of its most severe forms, the HELLP (hemolysis, elevated liver enzymes, low platelets) syndrome, are characterized by increased placental thrombosis based on a procoagulatory state in the mother. Several studies have investigated the role of the PAI-1 4G/5G polymorphism in pre-eclampsia, but no study has focused especially on HELLP syndrome. Therefore we aimed to assess the association between HELLP syndrome and the 4G/5G polymorphism in the PAI-1 gene. Genotyping of the PAI-1 4G/5G promoter polymorphism was performed in 102 Caucasian women with HELLP syndrome and 102 Caucasian women with uncomplicated pregnancies. The 4G/4G genotype was more frequent in women with HELLP syndrome than in controls (35.3% vs. 22.5%, respectively) but this difference was not significantly different (P = 0.129). The frequency of the 4G allele was 0.588 in patients and 0.515 in controls. These data suggest that women carrying a 4G/4G genotype of the PAI-1 gene are not at increased risk for developing HELLP syndrome and are thus in line with the majority of previous studies on the association between the PAI-1 4G/5G polymorphism and pre-eclampsia.
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Affiliation(s)
- Sabine Muetze
- Department of Obstetrics and Gynecology, Aachen University (RWTH), Aachen, Germany.
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Knowles JW, Wang H, Itakura H, Southwick A, Myers RM, Iribarren C, Fortmann SP, Go AS, Quertermous T, Hlatky MA. Association of polymorphisms in platelet and hemostasis system genes with acute myocardial infarction. Am Heart J 2007; 154:1052-8. [PMID: 18035074 DOI: 10.1016/j.ahj.2007.05.021] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2007] [Accepted: 05/05/2007] [Indexed: 10/22/2022]
Abstract
BACKGROUND Genetic polymorphisms may affect the balance between coagulation and fibrinolysis and thereby affect individual vulnerability to acute myocardial infarction (MI) among patients with underlying coronary atherosclerosis. METHODS We enrolled 1375 patients with an initial clinical presentation of coronary disease. We genotyped 49 single nucleotide polymorphisms (SNPs) in 9 coagulation system genes and compared patients who had an initial acute MI with patients who presented with stable exertional angina. RESULTS An SNP in CD36 (rs3211956) was significantly (P = .04) more common among patients who presented with acute MI (minor allele frequency 10.5%) than patients with stable exertional angina (minor allele frequency 8.0%). This association became marginally significant, however, after adjustment for conventional cardiac risk factors in an additive genetic model (odds ratio 1.34, CI 1.00-1.88, P = .053). An SNP in ITGB3 (Leu59Pro, rs5918) was slightly, but not significantly (P = .083), more common among patients with acute MI (minor allele frequency 14.5%) than among patients with stable exertional angina (minor allele frequency 12.0%). Two linked SNPs in THBD (Ala473Val, rs1042579; and rs3176123) were slightly, but not significantly (P = .079 and 0.052, respectively), less common among patients with acute MI (minor allele frequency 16.1%) than among patients with stable exertional angina (18.7% and 19.0%, respectively). CONCLUSIONS Four SNPs in platelet glycoprotein and hemostatic genes were nominally associated with acute MI rather than stable exertional angina as the initial clinical presentation of coronary artery disease. These findings are suggestive but require independent confirmation in larger studies.
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Affiliation(s)
- Gordon D O Lowe
- University of Glasgow, Royal Infirmary, Glasgow G31 2ER, UK.
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Graham I, Atar D, Borch-Johnsen K, Boysen G, Burell G, Cifkova R, Dallongeville J, De Backer G, Ebrahim S, Gjelsvik B, Herrmann-Lingen C, Hoes A, Humphries S, Knapton M, Perk J, Priori SG, Pyorala K, Reiner Z, Ruilope L, Sans-Menendez S, Op Reimer WS, Weissberg P, Wood D, Yarnell J, Zamorano JL, Walma E, Fitzgerald T, Cooney MT, Dudina A, Vahanian A, Camm J, De Caterina R, Dean V, Dickstein K, Funck-Brentano C, Filippatos G, Hellemans I, Kristensen SD, McGregor K, Sechtem U, Silber S, Tendera M, Widimsky P, Zamorano JL, Altiner A, Bonora E, Durrington PN, Fagard R, Giampaoli S, Hemingway H, Hakansson J, Kjeldsen SE, Larsen ML, Mancia G, Manolis AJ, Orth-Gomer K, Pedersen T, Rayner M, Ryden L, Sammut M, Schneiderman N, Stalenhoef AF, Tokgözoglu L, Wiklund O, Zampelas A. European guidelines on cardiovascular disease prevention in clinical practice: executive summary. Fourth Joint Task Force of the European Society of Cardiology and other societies on cardiovascular disease prevention in clinical practice (constituted by representatives of nine societies and by invited experts). ACTA ACUST UNITED AC 2007; 14 Suppl 2:E1-40. [PMID: 17726406 DOI: 10.1097/01.hjr.0000277984.31558.c4] [Citation(s) in RCA: 259] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Other experts who contributed to parts of the guidelines: Edmond Walma, Schoonhoven (The Netherlands), Tony Fitzgerald, Dublin (Ireland), Marie Therese Cooney, Dublin (Ireland), Alexandra Dudina, Dublin (Ireland) European Society of Cardiology (ESC) Committee for Practice Guidelines (CPG):, Alec Vahanian (Chairperson) (France), John Camm (UK), Raffaele De Caterina (Italy), Veronica Dean (France), Kenneth Dickstein (Norway), Christian Funck-Brentano (France), Gerasimos Filippatos (Greece), Irene Hellemans (The Netherlands), Steen Dalby Kristensen (Denmark), Keith McGregor (France), Udo Sechtem (Germany), Sigmund Silber (Germany), Michal Tendera (Poland), Petr Widimsky (Czech Republic), José Luis Zamorano (Spain) Document reviewers: Irene Hellemans (CPG Review Coordinator) (The Netherlands), Attila Altiner (Germany), Enzo Bonora (Italy), Paul N. Durrington (UK), Robert Fagard (Belgium), Simona Giampaoli(Italy), Harry Hemingway (UK), Jan Hakansson (Sweden), Sverre Erik Kjeldsen (Norway), Mogens Lytken Larsen (Denmark), Giuseppe Mancia (Italy), Athanasios J. Manolis (Greece), Kristina Orth-Gomer (Sweden), Terje Pedersen (Norway), Mike Rayner (UK), Lars Ryden (Sweden), Mario Sammut (Malta), Neil Schneiderman (USA), Anton F. Stalenhoef (The Netherlands), Lale Tokgözoglu (Turkey), Olov Wiklund (Sweden), Antonis Zampelas (Greece)
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Affiliation(s)
- Ian Graham
- Department of Cardiology, The Adelaide and Meath Hospital, Tallaght, Doublin, Ireland.
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Pruissen DMO, Rosendaal FR, Gorter JW, Garcia AA, Kappelle LJ, Algra A. Haemostatic genetic variants, ABO blood group and bleeding risk during oral anticoagulant treatment after cerebral ischaemia of arterial origin. J Neurol 2007; 254:1660-5. [DOI: 10.1007/s00415-007-0609-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2006] [Revised: 03/07/2007] [Accepted: 03/23/2007] [Indexed: 11/27/2022]
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Baker M, Rahman T, Hall D, Avery PJ, Mayosi BM, Connell JMC, Farrall M, Watkins H, Keavney B. The C-532T polymorphism of the angiotensinogen gene is associated with pulse pressure: a possible explanation for heterogeneity in genetic association studies of AGT and hypertension. Int J Epidemiol 2007; 36:1356-62. [PMID: 17998241 DOI: 10.1093/ije/dym213] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Many previous studies have investigated whether there is an association between genotypes at the angiotensinogen (AGT) gene and hypertensive status, but few have incorporated quantitative data. Although meta-analyses support a possible effect of AGT variants on blood pressure (BP), substantial unexplained between-study heterogeneity has been observed. We hypothesized that a primary effect of AGT variants on arterial stiffness (and thus pulse pressure) might explain such heterogeneity, and tested for such an effect in a family study. METHODS We studied 1425 individuals from 248 families ascertained through a proband with essential hypertension. BP was measured using 24 h ambulatory monitoring, and polymorphisms of the AGT gene that had been previously associated with hypertension and/or plasma angiotensinogen levels were typed. Pulse pressure was used as a measurement of arterial stiffness. RESULTS We observed a highly significant association between genotypes at the AGT C-532T polymorphism and pulse pressure (p = 0.00006). Each T allele was associated with a 5% lower pulse pressure (that is, an additive effect). This resulted from opposing genotypic effects to (slightly) lower systolic BP and (slightly) elevate DBP. CONCLUSIONS These results suggest that genetic variation at the angiotensinogen locus may primarily affect arterial stiffness, and therefore pulse pressure. The heterogeneity between previous genetic studies of AGT and hypertension status could in part be explained by this finding, since case selection criteria based on systolic BP, diastolic BP, or both would result in different levels of selection for the -532T allele.
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Affiliation(s)
- Michelle Baker
- The Institute of Human Genetics, Newcastle University, UK
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