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Rincón LM, Subirana I, Pérez del Villar C, Sánchez PL, Zamorano JL, Marrugat J, Elosua R. Predictive capacity of a genetic risk score for coronary artery disease in assessing recurrences and cardiovascular mortality among patients with myocardial infarction. Front Cardiovasc Med 2023; 10:1254066. [PMID: 37781316 PMCID: PMC10537937 DOI: 10.3389/fcvm.2023.1254066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 08/21/2023] [Indexed: 10/03/2023] Open
Abstract
Aim This study aimed to evaluate the capacity of a genetic risk score (GRS) for coronary artery disease (CAD) independent of classical cardiovascular risk factors to assess the risk of recurrence in patients with first myocardial infarction. The secondary aim was to determine the predictive value of this GRS. Methods We performed a meta-analysis of individual data from three studies, namely, a prospective study including 75 patients aged <55 years, a prospective study including 184 patients with a mean age of 60.5 years, and a case-control study (77 cases and 160 controls) nested in a cohort of patients with first myocardial infarction. A GRS including 12 CAD genetic variants independent of classical cardiovascular risk factors was developed. The outcome was a composite of cardiovascular mortality and recurrent acute coronary syndrome. Results The GRS was associated with a higher risk of recurrence [hazard ratio = 1.24; 95% confidence interval (CI): 1.04-1.47]. The inclusion of the GRS in the clinical model did not increase the model's discriminative capacity (change in C-statistic/area under the curve: 0.009; 95% CI: -0.007 to 0.025) but improved its reclassification (continuous net reclassification index: 0.29; 95% CI: 0.08-0.51). Conclusion The GRS for CAD, independent of classical cardiovascular risk factors, was associated with a higher risk of recurrence in patients with first myocardial infarction. The predictive capacity of this GRS identified a subgroup of high-risk patients who could benefit from intensive preventive strategies.
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Affiliation(s)
- Luis Miguel Rincón
- Cardiology Department, Hospital Universitario de Salamanca–IBSAL, Universidad de Salamanca, Salamanca, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
- Universidad de Alcalá, Madrid, Spain
| | - Isaac Subirana
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
- Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - Candelas Pérez del Villar
- Cardiology Department, Hospital Universitario de Salamanca–IBSAL, Universidad de Salamanca, Salamanca, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
| | - Pedro L. Sánchez
- Cardiology Department, Hospital Universitario de Salamanca–IBSAL, Universidad de Salamanca, Salamanca, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
| | - José Luis Zamorano
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
- Universidad de Alcalá, Madrid, Spain
- Cardiology Department, Hospital Ramón y Cajal, Universidad de Alcalá, Madrid, Spain
| | - Jaume Marrugat
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
- Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - Roberto Elosua
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
- Hospital del Mar Medical Research Institute, Barcelona, Spain
- Faculty of Medicine, University of Vic-Central University of Catalonia, Vic, Spain
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Jin S, Choi EJ, Choi YJ, Min WK, Park JY, Yoon SZ. Relationship between Arachidonate 5-Lipoxygenase-Activating Protein Gene and Peripheral Arterial Disease in Elderly Patients Undergoing General Surgery: A Retrospective Observational Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1027. [PMID: 36673783 PMCID: PMC9858772 DOI: 10.3390/ijerph20021027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 01/01/2023] [Accepted: 01/04/2023] [Indexed: 06/17/2023]
Abstract
Patients with peripheral arterial disease (PAD) are at a higher risk of developing postoperative complications. Arachidonate 5-lipoxygenase-activating protein (ALOX5AP) plays an important role in atherosclerosis pathogenesis. In this study, the relationship between PAD and several single nucleotide polymorphisms (SNPs) of ALOX5AP (rs17216473, rs10507391, rs4769874, rs9551963, rs17222814, and rs7222842) was investigated in elderly patients undergoing general surgery. The medical records of 129 patients aged > 55 years who underwent elective general surgery between May 2018 and August 2019 were retrospectively reviewed. The A/A in rs17216473, A/A in rs10507391, G/G in rs4769874, and A/A in rs9551963 were calculated as 0 points and the rest as 1 point to define the genetic risk score. The prevalence of PAD tended to increase with higher genetic risk scores (patients had less ALOX5AP gene polymorphism of A/A in rs17216473, A/A in rs10507391, G/G in rs4769874, or A/A in rs9551963) (p = 0.005). Multivariate logistic regression analysis revealed that the genetic risk score (p = 0.009) and age (p = 0.007) were positively correlated with the prevalence of PAD. Genetic polymorphisms of ALOX5AP and age were associated with the prevalence of PAD in this study.
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Affiliation(s)
- Sejong Jin
- Department of Neuroscience, Korea University College of Medicine, Seoul 02841, Republic of Korea
| | - Eun-Ji Choi
- Department of Dental Anesthesia and Pain Medicine, School of Dentistry, Pusan National University, Dental Research Institute, Yangsan 50612, Republic of Korea
| | - Yoon Ji Choi
- Department of Anesthesiology and Pain Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Seoul 02841, Republic of Korea
| | - Won Kee Min
- Department of Anesthesiology and Pain Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Seoul 02841, Republic of Korea
| | - Ju Yeon Park
- Department of Anesthesiology and Pain Medicine, Daedong Hospital, Busan 47737, Republic of Korea
| | - Seung Zhoo Yoon
- Department of Anesthesiology and Pain Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul 02841, Republic of Korea
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Rincón LM, Sanmartín M, Alonso GL, Rodríguez JA, Muriel A, Casas E, Navarro M, Carbonell A, Lázaro C, Fernández S, González P, Rodríguez M, Jiménez-Mena M, Fernández-Golfín C, Esteban A, García-Bermejo ML, Zamorano JL. Una puntuación de riesgo genético predice recurrencias en pacientes jóvenes con infarto agudo de miocardio. Rev Esp Cardiol 2020. [DOI: 10.1016/j.recesp.2019.08.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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A genetic risk score predicts recurrent events after myocardial infarction in young adults. ACTA ACUST UNITED AC 2019; 73:623-631. [PMID: 31629691 DOI: 10.1016/j.rec.2019.08.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Accepted: 08/05/2019] [Indexed: 12/22/2022]
Abstract
INTRODUCTION AND OBJECTIVES To evaluate whether a genetic risk score (GRS) improves prediction of recurrent events in young nondiabetic patients presenting with an acute myocardial infarction (AMI) and identifies a more aggressive form of atherosclerosis. METHODS We conducted a prospective study with consecutive nondiabetic patients aged <55 years presenting with AMI. We performed a genetic test, cardiac computed tomography, and analyzed several biomarkers. We studied the association of a GRS composed of 11 genetic variants and a primary composite endpoint (cardiovascular mortality, a recurrent event, and cardiac hospitalization). RESULTS A total of 81 patients were studied and followed up for a median of 4.1 years. There were 24 recurrent cardiovascular events. Compared with the general population, study participants had a higher prevalence of 9 out of 11 risk alleles. The GRS was significantly associated with recurrent cardiovascular events, especially when baseline low-density lipoprotein cholesterol (LDL-C) levels were elevated. Compared with the low-risk GRS tertile, the multivariate-adjusted HR for recurrences was 10.2 (95%CI, 1.1-100.3; P=.04) for the intermediate-risk group and was 20.7 (2.4-181.0; P=.006) for the high-risk group when LDL-C was≥2.8mmol/L (≥ 110mg/dL). Inclusion of the GRS improved the C-statistic (ΔC-statistic=0.086), cNRI (continuous net reclassification improvement) (30%), and the IDI (integrated discrimination improvement) index (0.05). Cardiac computed tomography frequently detected coronary calcified atherosclerosis but had limited value for prediction of recurrences. No association was observed between metalloproteinases, GRS and recurrences. CONCLUSIONS A multilocus GRS may identify individuals at increased risk of long-term recurrences among young nondiabetic patients with AMI and improve clinical risk stratification models, particularly among patients with high baseline LDL-C levels.
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Li Y, Xu X, Zhang D, Cheng W, Zhang Y, Yu B, Zhang Y. Genetic variation in the leukotriene pathway is associated with myocardial infarction in the Chinese population. Lipids Health Dis 2019; 18:25. [PMID: 30678701 PMCID: PMC6346589 DOI: 10.1186/s12944-019-0968-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 01/08/2019] [Indexed: 01/03/2023] Open
Abstract
Background Genetic variation in the genes ALOX5 (arachidonate 5-lipoxygenase), ALOX5AP (arachidonate 5-lipoxygenase-activating protein) and LTA4H (leukotriene A4 hydrolase) has previously been shown to contribute to the risk of MI (myocardial infarction) in Caucasian and African American populations. All genes encode proteins playing a role in the synthesis of the pro-inflammatory leukotriene B mediators, possibly providing a link between MI and inflammation. The aim of the present study was to investigate whether these associations could be confirmed in the study of China MI patients. The study included 401 Han Chinese MI patients and 409 controls. Six tag single nucleotide polymorphisms (SNPs)—ALOX5 rs12762303 and rs12264801, ALOX5AP rs10507391, LTA4H rs2072512, rs2540487 and rs2540477—were selected. SNP genotyping was performed by an improved multiplex ligation detection reaction assay. Results The rs2540487 genotype was associated with the risk of MI in overdominant model (P = 0.008). rs12762303 and rs10507391 SNPs were significantly associated with lipid levels in MI patients (P < 0.006–0.008). Several SNPs interacted with alcohol consumption, cigarette smoking, and hypertension to modify TC, TG, LDL-C and CRE levels, and the risk of MI (P < 0.0017 for all). No association between the SNPs of LT pathway and susceptibility to MI was found (P > 0.05 for all). Conclusions Taken together, this study provides additional evidence that functional genetic variation of the LT pathway can mediate atherogenic processes and the risk of MI in Chinese.
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Affiliation(s)
- Yilan Li
- Department of Cardiology, the 2nd Affiliated Hospital of Harbin Medical University, Harbin, 150001, China.,Key Laboratory of Myocardial Ischemia, Ministry of Education, Harbin Medical University, Harbin, 150001, China
| | - Xueming Xu
- Department of Cardiology, the 2nd Affiliated Hospital of Harbin Medical University, Harbin, 150001, China.,Key Laboratory of Myocardial Ischemia, Ministry of Education, Harbin Medical University, Harbin, 150001, China
| | - Dandan Zhang
- Department of Cardiology, the 2nd Affiliated Hospital of Harbin Medical University, Harbin, 150001, China.,Key Laboratory of Myocardial Ischemia, Ministry of Education, Harbin Medical University, Harbin, 150001, China
| | - Wei Cheng
- Department of Cardiology, the 2nd Affiliated Hospital of Harbin Medical University, Harbin, 150001, China
| | - Yanan Zhang
- Department of Cardiology, Heilongjiang Provincial Hospital, Harbin, 150001, China
| | - Bo Yu
- Department of Cardiology, the 2nd Affiliated Hospital of Harbin Medical University, Harbin, 150001, China.,Key Laboratory of Myocardial Ischemia, Ministry of Education, Harbin Medical University, Harbin, 150001, China
| | - Yao Zhang
- Department of Cardiology, the 2nd Affiliated Hospital of Harbin Medical University, Harbin, 150001, China. .,Key Laboratory of Myocardial Ischemia, Ministry of Education, Harbin Medical University, Harbin, 150001, China.
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Iribarren C, Lu M, Jorgenson E, Martínez M, Lluis-Ganella C, Subirana I, Salas E, Elosua R. Weighted Multi-marker Genetic Risk Scores for Incident Coronary Heart Disease among Individuals of African, Latino and East-Asian Ancestry. Sci Rep 2018; 8:6853. [PMID: 29717161 PMCID: PMC5931622 DOI: 10.1038/s41598-018-25128-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 03/22/2018] [Indexed: 02/06/2023] Open
Abstract
We examined the clinical utility of two multi-locus genetic risk scores (GRSs) previously validated in Europeans among persons of African (AFR; n = 2,089), Latino (LAT; n = 4,349) and East-Asian (EA; n = 4,804) ancestry. We used data from the GERA cohort (30-79 years old, 68 to 73% female). We utilized two GRSs with 12 and 51 SNPs, respectively, and the Framingham Risk Score (FRS) to estimate 10-year CHD risk. After a median 8.7 years of follow-up, 450 incident CHD events were documented (95 in AFR, 316 in LAT and 39 EA, respectively). In a model adjusting for principal components and risk factors, tertile 3 vs. tertile 1 of GRS_12 was associated with 1.86 (95% CI, 1.15-3.01), 1.52 (95% CI, 1.02-2.25) and 1.19 (95% CI, 0.77-1.83) increased hazard of CHD in AFR, LAT and EA, respectively. Inclusion of the GRSs in models containing the FRS did not increase the C-statistic but resulted in net overall reclassification of 10% of AFR, 7% LAT and EA and in reclassification of 13% of AFR and EA as well as 10% LAT in the intermediate FRS risk subset. Our results support the usefulness of incorporating genetic information into risk assessment for primary prevention among minority subjects in the U.S.
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Affiliation(s)
- Carlos Iribarren
- Kaiser Permanente Northern California Division of Research, Oakland, CA, USA.
| | - Meng Lu
- Kaiser Permanente Northern California Division of Research, Oakland, CA, USA
| | - Eric Jorgenson
- Kaiser Permanente Northern California Division of Research, Oakland, CA, USA
| | | | | | - Isaac Subirana
- CIBER of Epidemiology and Public Health, Barcelona, Spain.,Cardiovascular Epidemiology and Genetics, IMIM, Barcelona, Spain
| | | | - Roberto Elosua
- Cardiovascular Epidemiology and Genetics, IMIM, Barcelona, Spain.,CIBER of Cardiovascular Diseases (CIBERCV), Barcelona, Spain
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Common Polymorphisms in the 5-Lipoxygenase Pathway and Risk of Incident Myocardial Infarction: A Danish Case-Cohort Study. PLoS One 2016; 11:e0167217. [PMID: 27893808 PMCID: PMC5125697 DOI: 10.1371/journal.pone.0167217] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Accepted: 11/10/2016] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND The 5-lipoxygenase pathway (5-LOX) has been implicated in the development of cardiovascular disease and studies have suggested that genetic polymorphisms related to key enzymes in this pathway may confer risk of myocardial infarction (MI). This study investigated the association of pre-selected genetic polymorphisms in four candidate genes of 5-LOX (arachidonate 5-lipoxygenase and its activating protein (ALOX-5 and FLAP), leukotriene A4 hydroxylase (LTA4-H) and leukotriene C4 synthase (LTC4-S)) with incident MI. METHODS In a Danish cohort including 57,053 participants, aged 50-64 at enrolment and recruited from 1993-97, we conducted a case-cohort study including cases with incident MI and a randomly selected sub cohort of 3,000 participants. Cases were identified from national registries through July 2013. A total of 22 SNPs were selected and genotyped using the commercially available KASP™ assay. A tandem-repeat polymorphism, located in the ALOX-5 gene, was genotyped by multi-titre plate sequencing. Haplotypes were inferred using PHASE 2.1. RESULTS During a median follow-up of 17.0 years we identified 3,089 cases of incident MI. In FLAP, two SNPs were negatively associated with incident MI (rs9551963 & rs17222842) while one SNP (rs2247570) located in LTA4-H, was associated with higher risk of MI when comparing subjects with two copies of the variant allele to homozygotes for the wild type. However, only rs17222842 remained significantly associated with MI after correcting for multiple testing. Furthermore, the promoter polymorphism rs59439148 was associated with risk of MI in men. For male carriers of two variant alleles we found a hazard ratio of 1.63 (95% CI: 1.06;2.52) compared to homozygotes for the wild type. Previously described haplotypes (Hap-A -B, -E and -K) were not associated with MI in our population. CONCLUSION In conclusion, some common polymorphisms in the 5-lipoxygenase pathway were modestly associated with incident MI, suggesting a potential role for this pathway in the development of cardiovascular disease.
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Iribarren C, Lu M, Jorgenson E, Martínez M, Lluis-Ganella C, Subirana I, Salas E, Elosua R. Clinical Utility of Multimarker Genetic Risk Scores for Prediction of Incident Coronary Heart Disease: A Cohort Study Among Over 51 000 Individuals of European Ancestry. ACTA ACUST UNITED AC 2016; 9:531-540. [PMID: 27780846 DOI: 10.1161/circgenetics.116.001522] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Accepted: 09/28/2016] [Indexed: 12/28/2022]
Abstract
BACKGROUND We evaluated whether including multilocus genetic risk scores (GRSs) into the Framingham Risk Equation improves the predictive capacity, discrimination, and reclassification of asymptomatic individuals with respect to coronary heart disease (CHD) risk. METHODS AND RESULTS We performed a cohort study among 51 954 European-ancestry members of a Northern California integrated healthcare system (67% female; mean age 59) free of CHD at baseline (2007-2008). Four GRSs were constructed using between 8 and 51 previously identified genetic variants. After a mean (±SD) follow-up of 5.9 (±1.5) years, 1864 incident CHD events were documented. All GRSs were linearly associated with CHD in a model adjusted by individual risk factors: hazard ratio (95% confidence interval) per SD unit: 1.21 (1.15-1.26) for GRS_8, 1.20 (1.15-1.26) for GRS_12, 1.23 (1.17-1.28) for GRS_36, and 1.23 (1.17-1.28) for GRS_51. Inclusion of the GRSs improved the C statistic (ΔC statistic =0.008 for GRS_8 and GRS_36; 0.007 for GRS_12; and 0.009 for GRS_51; all P<0.001). The net reclassification improvement was 5% for GRS_8, GRS_12, and GRS_36 and 4% for GRS_51 in the entire cohort and was (after correcting for bias) 9% for GRS_8 and GRS_12 and 7% for GRS_36 and GRS_51 when analyzing those classified as intermediate Framingham risk (10%-20%). The number required to treat to prevent 1 CHD after selectively treating with statins up-reclassified subjects on the basis of genetic information was 36 for GRS_8 and GRS_12, 41 for GRS_36, and 43 for GRS_51. CONCLUSIONS Our results demonstrate significant and clinically relevant incremental discriminative/predictive capability of 4 multilocus GRSs for incident CHD among subjects of European ancestry.
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Affiliation(s)
- Carlos Iribarren
- From the Kaiser Permanente Northern California Division of Research, Oakland, CA (C.I., M.L., E.J.); Gendiag, Inc/Ferrer inCode, Inc, Barcelona, Spain (M.M., C.L.-G., E.S.); CIBER of Epidemiology and Public Health, Barcelona, Spain (I.S.); and Cardiovascular Epidemiology & Genetics, IMIM, Barcelona, Spain (I.S., R.E.).
| | - Meng Lu
- From the Kaiser Permanente Northern California Division of Research, Oakland, CA (C.I., M.L., E.J.); Gendiag, Inc/Ferrer inCode, Inc, Barcelona, Spain (M.M., C.L.-G., E.S.); CIBER of Epidemiology and Public Health, Barcelona, Spain (I.S.); and Cardiovascular Epidemiology & Genetics, IMIM, Barcelona, Spain (I.S., R.E.)
| | - Eric Jorgenson
- From the Kaiser Permanente Northern California Division of Research, Oakland, CA (C.I., M.L., E.J.); Gendiag, Inc/Ferrer inCode, Inc, Barcelona, Spain (M.M., C.L.-G., E.S.); CIBER of Epidemiology and Public Health, Barcelona, Spain (I.S.); and Cardiovascular Epidemiology & Genetics, IMIM, Barcelona, Spain (I.S., R.E.)
| | - Manuel Martínez
- From the Kaiser Permanente Northern California Division of Research, Oakland, CA (C.I., M.L., E.J.); Gendiag, Inc/Ferrer inCode, Inc, Barcelona, Spain (M.M., C.L.-G., E.S.); CIBER of Epidemiology and Public Health, Barcelona, Spain (I.S.); and Cardiovascular Epidemiology & Genetics, IMIM, Barcelona, Spain (I.S., R.E.)
| | - Carla Lluis-Ganella
- From the Kaiser Permanente Northern California Division of Research, Oakland, CA (C.I., M.L., E.J.); Gendiag, Inc/Ferrer inCode, Inc, Barcelona, Spain (M.M., C.L.-G., E.S.); CIBER of Epidemiology and Public Health, Barcelona, Spain (I.S.); and Cardiovascular Epidemiology & Genetics, IMIM, Barcelona, Spain (I.S., R.E.)
| | - Isaac Subirana
- From the Kaiser Permanente Northern California Division of Research, Oakland, CA (C.I., M.L., E.J.); Gendiag, Inc/Ferrer inCode, Inc, Barcelona, Spain (M.M., C.L.-G., E.S.); CIBER of Epidemiology and Public Health, Barcelona, Spain (I.S.); and Cardiovascular Epidemiology & Genetics, IMIM, Barcelona, Spain (I.S., R.E.)
| | - Eduardo Salas
- From the Kaiser Permanente Northern California Division of Research, Oakland, CA (C.I., M.L., E.J.); Gendiag, Inc/Ferrer inCode, Inc, Barcelona, Spain (M.M., C.L.-G., E.S.); CIBER of Epidemiology and Public Health, Barcelona, Spain (I.S.); and Cardiovascular Epidemiology & Genetics, IMIM, Barcelona, Spain (I.S., R.E.)
| | - Roberto Elosua
- From the Kaiser Permanente Northern California Division of Research, Oakland, CA (C.I., M.L., E.J.); Gendiag, Inc/Ferrer inCode, Inc, Barcelona, Spain (M.M., C.L.-G., E.S.); CIBER of Epidemiology and Public Health, Barcelona, Spain (I.S.); and Cardiovascular Epidemiology & Genetics, IMIM, Barcelona, Spain (I.S., R.E.)
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Elevated levels of leukotriene B4 and thromboxane B2 distinguish chest pain of cardiac and non cardiac origin. Indian Heart J 2013; 65:295-9. [PMID: 23809385 DOI: 10.1016/j.ihj.2013.04.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2012] [Revised: 12/12/2012] [Accepted: 04/03/2013] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVE Myocardial infarction (MI) is often preceded by severe chest pain. The use of inflammatory markers to distinguish between chest pain of cardiac and non cardiac origin are not well reported. The aim of the study was to distinguish the chest pain of non cardiac and cardiac origin by using reliable inflammatory markers. METHODS The present study enrolled 80 subjects including chest pain which lead to myocardial infarction (n=40), non-cardiac chest pain (CP) patients (n=20) and healthy volunteers (N) (n=20). Leukotriene B4 (LTB4) and thromboxane B2 (TXB2) levels were analyzed along with hs-CRP. RESULTS Receiver operating characteristic (ROC) curve analysis showed LTB4 and TXB2 to be a good discriminator between patients with chest pain of cardiac and non cardiac in origin. The area under the curve was found to be 0.988 and 0.925 for LTB4 and TXB2, respectively when compared with hs-CRP. The sensitivity and specificity of LTB4 and TXB2 were found to be 90, 85% and 95, 90%, respectively. CONCLUSION The measurement of LTB4 and TXB2 levels may therefore be useful to distinguish the chest pain leading to MI from that of non cardiac in origin and for the management of the disease.
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Zhao J, Goldberg J, Vaccarino V. Leukotriene A4 hydrolase haplotype, diet and atherosclerosis: a twin study. Atherosclerosis 2013; 226:238-44. [PMID: 23153620 PMCID: PMC3630507 DOI: 10.1016/j.atherosclerosis.2012.10.048] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2012] [Revised: 10/15/2012] [Accepted: 10/16/2012] [Indexed: 01/02/2023]
Abstract
OBJECTIVE Atherosclerosis is an inflammatory process resulting from the interaction between genetic and environmental factors. Leukotrienes are inflammatory mediators generated from arachidonic acid, and genetic polymorphisms involved in leukotriene metabolism are implicated in atherosclerosis. The objectives of this study are to examine whether genetic variants in key leukotriene enzymes are associated with atherosclerosis, and whether dietary intake of competing leukotriene substrates modifies the effect of leukotriene variants on atherosclerosis. METHODS Atherosclerosis was assessed by common carotid intima-media thickness (IMT) using ultrasound. Sequence variants within arachidonate 5-lipoxygenase activating protein (ALOX5AP) and leukotriene A4 hydrolase (LTA4H) genes were analyzed with 32 single nucleotide polymorphisms (SNPs) in 169 Caucasian twin pairs from the Vietnam Era Twin Registry. The associations between genetic polymorphisms and carotid atherosclerosis, and gene × diet interactions were examined by generalized estimating equation controlling for potential confounders. RESULTS A six-SNP haplotype in LTA4H, designated HapE, was significantly associated with carotid IMT after adjusting for known coronary risk factors. Twins carrying HapE had a much lower IMT compared to twins not carrying (695 μm vs. 750 μm, p = 0.0007). Moreover, dietary intake of polyunsaturated fatty acids strongly augmented the cardioprotective effect of HapE among those with this haplotype but not those without, suggesting a haplotype × diet interaction (interaction P(HapE×n-3) = 0.03, P(HapE×n-6) = 0.015). CONCLUSION We identified a novel leukotriene haplotype that appears to be protective toward subclinical atherosclerosis. This association is modified by dietary intake of polyunsaturated fatty acids.
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Affiliation(s)
- Jinying Zhao
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, 1440 Canal Street, Suite 2010-SL18, New Orleans, LA 70112, United States.
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Portnichenko AG, Vasilenko MI, Moĭbenko. AA. Hypoxic preconditioning prevents the induction and activation of 5-lipoxygenase during ischemia and reperfusion of rat heart. ACTA ACUST UNITED AC 2012. [DOI: 10.15407/fz58.04.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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12
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Capra V, Bäck M, Barbieri SS, Camera M, Tremoli E, Rovati GE. Eicosanoids and Their Drugs in Cardiovascular Diseases: Focus on Atherosclerosis and Stroke. Med Res Rev 2012; 33:364-438. [DOI: 10.1002/med.21251] [Citation(s) in RCA: 81] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Valérie Capra
- Department of Pharmacological Sciences; University of Milan; Via Balzaretti 9 20133 Milan Italy
| | - Magnus Bäck
- Department of Cardiology and Center for Molecular Medicine; Karolinska University Hospital; Stockholm Sweden
| | | | - Marina Camera
- Department of Pharmacological Sciences; University of Milan; Via Balzaretti 9 20133 Milan Italy
- Centro Cardiologico Monzino; I.R.C.C.S Milan Italy
| | - Elena Tremoli
- Department of Pharmacological Sciences; University of Milan; Via Balzaretti 9 20133 Milan Italy
- Centro Cardiologico Monzino; I.R.C.C.S Milan Italy
| | - G. Enrico Rovati
- Department of Pharmacological Sciences; University of Milan; Via Balzaretti 9 20133 Milan Italy
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13
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Stock NS, Bain G, Zunic J, Li Y, Ziff J, Roppe J, Santini A, Darlington J, Prodanovich P, King CD, Baccei C, Lee C, Rong H, Chapman C, Broadhead A, Lorrain D, Correa L, Hutchinson JH, Evans JF, Prasit P. 5-Lipoxygenase-Activating Protein (FLAP) Inhibitors. Part 4: Development of 3-[3-tert-Butylsulfanyl-1-[4-(6-ethoxypyridin-3-yl)benzyl]-5-(5-methylpyridin-2-ylmethoxy)-1H-indol-2-yl]-2,2-dimethylpropionic Acid (AM803), a Potent, Oral, Once Daily FLAP Inhibitor. J Med Chem 2011; 54:8013-29. [DOI: 10.1021/jm2008369] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- Nicholas S. Stock
- Departments
of †Chemistry, ‡Biology, and §Drug Metabolism, Amira Pharmaceuticals, 9535 Waples Road,
Suite 100, San Diego, California 92121, United
States
| | - Gretchen Bain
- Departments
of †Chemistry, ‡Biology, and §Drug Metabolism, Amira Pharmaceuticals, 9535 Waples Road,
Suite 100, San Diego, California 92121, United
States
| | - Jasmine Zunic
- Departments
of †Chemistry, ‡Biology, and §Drug Metabolism, Amira Pharmaceuticals, 9535 Waples Road,
Suite 100, San Diego, California 92121, United
States
| | - Yiwei Li
- Departments
of †Chemistry, ‡Biology, and §Drug Metabolism, Amira Pharmaceuticals, 9535 Waples Road,
Suite 100, San Diego, California 92121, United
States
| | - Jeannie Ziff
- Departments
of †Chemistry, ‡Biology, and §Drug Metabolism, Amira Pharmaceuticals, 9535 Waples Road,
Suite 100, San Diego, California 92121, United
States
| | - Jeffrey Roppe
- Departments
of †Chemistry, ‡Biology, and §Drug Metabolism, Amira Pharmaceuticals, 9535 Waples Road,
Suite 100, San Diego, California 92121, United
States
| | - Angelina Santini
- Departments
of †Chemistry, ‡Biology, and §Drug Metabolism, Amira Pharmaceuticals, 9535 Waples Road,
Suite 100, San Diego, California 92121, United
States
| | - Janice Darlington
- Departments
of †Chemistry, ‡Biology, and §Drug Metabolism, Amira Pharmaceuticals, 9535 Waples Road,
Suite 100, San Diego, California 92121, United
States
| | - Pat Prodanovich
- Departments
of †Chemistry, ‡Biology, and §Drug Metabolism, Amira Pharmaceuticals, 9535 Waples Road,
Suite 100, San Diego, California 92121, United
States
| | - Christopher D. King
- Departments
of †Chemistry, ‡Biology, and §Drug Metabolism, Amira Pharmaceuticals, 9535 Waples Road,
Suite 100, San Diego, California 92121, United
States
| | - Christopher Baccei
- Departments
of †Chemistry, ‡Biology, and §Drug Metabolism, Amira Pharmaceuticals, 9535 Waples Road,
Suite 100, San Diego, California 92121, United
States
| | - Catherine Lee
- Departments
of †Chemistry, ‡Biology, and §Drug Metabolism, Amira Pharmaceuticals, 9535 Waples Road,
Suite 100, San Diego, California 92121, United
States
| | - Haojing Rong
- Departments
of †Chemistry, ‡Biology, and §Drug Metabolism, Amira Pharmaceuticals, 9535 Waples Road,
Suite 100, San Diego, California 92121, United
States
| | - Charles Chapman
- Departments
of †Chemistry, ‡Biology, and §Drug Metabolism, Amira Pharmaceuticals, 9535 Waples Road,
Suite 100, San Diego, California 92121, United
States
| | - Alex Broadhead
- Departments
of †Chemistry, ‡Biology, and §Drug Metabolism, Amira Pharmaceuticals, 9535 Waples Road,
Suite 100, San Diego, California 92121, United
States
| | - Dan Lorrain
- Departments
of †Chemistry, ‡Biology, and §Drug Metabolism, Amira Pharmaceuticals, 9535 Waples Road,
Suite 100, San Diego, California 92121, United
States
| | - Lucia Correa
- Departments
of †Chemistry, ‡Biology, and §Drug Metabolism, Amira Pharmaceuticals, 9535 Waples Road,
Suite 100, San Diego, California 92121, United
States
| | - John H. Hutchinson
- Departments
of †Chemistry, ‡Biology, and §Drug Metabolism, Amira Pharmaceuticals, 9535 Waples Road,
Suite 100, San Diego, California 92121, United
States
| | - Jilly F. Evans
- Departments
of †Chemistry, ‡Biology, and §Drug Metabolism, Amira Pharmaceuticals, 9535 Waples Road,
Suite 100, San Diego, California 92121, United
States
| | - Peppi Prasit
- Departments
of †Chemistry, ‡Biology, and §Drug Metabolism, Amira Pharmaceuticals, 9535 Waples Road,
Suite 100, San Diego, California 92121, United
States
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14
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Huang H, Zeng Z, Li J, Zhang L, Chen Y. Variants of arachidonate 5-lipoxygenase-activating protein (ALOX5AP) gene and risk of coronary heart disease: A meta-analysis. Arch Med Res 2011; 41:634-41. [PMID: 21199733 DOI: 10.1016/j.arcmed.2010.11.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2010] [Accepted: 10/21/2010] [Indexed: 02/05/2023]
Abstract
BACKGROUND AND AIMS Previous studies indicated that the arachidonate 5-lipoxygenase-activating protein (ALOX5AP) gene polymorphisms are associated with risk of coronary heart disease (CHD). However, other studies have yielded contradictory results. This meta-analysis investigated the relationship between variants of arachidonate 5-lipoxygenase-activating protein (ALOX5AP) gene and CHD. METHODS We identified all studies published before January 2010 through computer-based searches of PubMed, EMBASE, Google Scholar databases, and CNKI (Chinese National Knowledge Infrastructure). Data were extracted by two authors and pooled odds ratio (OR) and 95% confidence interval (CI) were calculated. RESULTS In this meta-analysis, HapA haplotype (rs17222814G-rs10507391T-rs4769874G-rs9551963A) was associated with myocardial infarction (MI) (OR = 1.37, 95% CI: 1.02-1.82). Regarding the HapB haplotype (rs17216473A-rs10507391A- rs9315050A- rs17222842G), there was a significant association with CHD (OR = 1.33, 95% CI: 1.10-1.62). For the rs17222814, rs10507391, rs4769874, rs9551963, rs17216473, rs9315050 and rs9579646 polymorphisms, there were no associations with CHD. For the rs17222842 polymorphism, there was a marginal association with the risk of CHD (OR = 1.17, 95% CI: 1.00-1.36). CONCLUSIONS In this meta-analysis, the HapB haplotype and rs1722842 polymorphism in ALOX5AP gene were associated with CHD, and the HapA haplotype was associated with risk of MI. The HapB haplotype may be a predictor to the risk of CHD.
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Affiliation(s)
- Hao Huang
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, P.R. China
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15
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Hartiala J, Li D, Conti DV, Vikman S, Patel Y, Tang WHW, Brennan ML, Newman JW, Stephensen CB, Armstrong P, Hazen SL, Allayee H. Genetic contribution of the leukotriene pathway to coronary artery disease. Hum Genet 2011; 129:617-27. [PMID: 21293878 PMCID: PMC3092945 DOI: 10.1007/s00439-011-0963-3] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2010] [Accepted: 01/27/2011] [Indexed: 12/25/2022]
Abstract
We evaluated the genetic contribution of the leukotriene (LT) pathway to risk of coronary artery disease (CAD) in 4,512 Caucasian and African American subjects ascertained through elective cardiac evaluation. Of the three previously associated variants, the shorter “3” and “4” alleles of a promoter repeat polymorphism in ALOX5 increased risk of CAD in African Americans (OR = 1.4, 95% CI 1.0–1.9; p = 0.04), whereas a haplotype of LTA4H (HapK) was associated with CAD in Caucasians (OR = 1.2, 95% CI 1.01–1.4; p = 0.03). In Caucasians, first-stage analysis of 254 haplotype-tagging SNPs in 15 LT pathway genes with follow-up of 19 variants in stage 2 revealed an LTA4H SNP (rs2540477) that increased risk of CAD (OR = 1.2, 95% CI 1.1–1.5; p = 0.003) and a PLA2G4A SNP (rs12746200) that decreased risk of CAD (OR = 0.7, 95% CI 0.6–0.9; p = 0.0007). The PLA2G4A rs12746200 variant also decreased risk of experiencing a major adverse cardiac event (MACE = myocardial infarction, stroke, or death) over 3 years of follow-up (HR = 0.7, 95% CI 0.5–0.9; p = 0.01), consistent with its cardioprotective effect. Functional experiments demonstrated that stimulated monocytes from carriers of LTA4H variants HapK or rs2540477 had 50% (p = 0.002) and 33% (p = 0.03) higher LTB4 production, respectively, compared to non-carriers. These ex vivo results are consistent with LTB4 being the direct product of the reaction catalyzed by LTA4H and its role in promoting monocyte chemotaxis to sites of inflammation, including the artery wall of atherosclerotic lesions. Taken together, this study provides additional evidence that functional genetic variation of the LT pathway can mediate atherogenic processes and the risk of CAD in humans.
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Affiliation(s)
- Jaana Hartiala
- Department of Preventive Medicine, USC Keck School of Medicine, Los Angeles, CA 90033, USA
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16
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Poeckel D, Funk CD. The 5-lipoxygenase/leukotriene pathway in preclinical models of cardiovascular disease. Cardiovasc Res 2010; 86:243-53. [PMID: 20093252 DOI: 10.1093/cvr/cvq016] [Citation(s) in RCA: 123] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Leukotrienes (LTs) derived from 5-lipoxygenase (5-LO) activity are most widely known for their actions during acute inflammation and asthma. 5-LO/LT pathway involvement in cardiovascular disease (CVD) pathogenesis has come to the forefront based on provocative human genetic/population and animal studies leading to the hypothesis that this pathway promotes atherosclerosis, abdominal aortic aneurysm, and myocardial infarction/reperfusion injury via increased leucocyte chemotaxis, vascular inflammation and enhanced permeability, and subsequent tissue/matrix degeneration. A series of pre-clinical studies have tested this hypothesis by means of genetic or pharmacological inhibition of either the LT biosynthesis axis (5-LO, 5-LO-activating protein, LTA(4) hydrolase, LTC(4) synthase) or the cognate LT receptors. Here, we summarize, compare, and analyse these animal studies and relate their findings to human disease pathogenesis. We draw a complex picture of 5-LO/LT participation in cardiovascular disorders, which is further complicated by marked differences between species. Moreover, we discuss how the cytokine footprint of the respective pathological conditions determines the expression level and hence, the contribution of components of the pathway to the overall disease state. Current knowledge implies a role for 5-LO and LTs during the early/acute phase of CVD, but our understanding of a putative 5-LO/LT involvement in more advanced stages of CVD is limited, thereby preventing simple extrapolation of findings from animal studies to humans.
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Affiliation(s)
- Daniel Poeckel
- Department of Physiology, Queen's University, 433 Botterell Hall, Kingston, ON, Canada K7L 3N6
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