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Hall M, Skogholt AH, Surakka I, Dalen H, Almaas E. Genome-wide association studies reveal differences in genetic susceptibility between single events vs. recurrent events of atrial fibrillation and myocardial infarction: the HUNT study. Front Cardiovasc Med 2024; 11:1372107. [PMID: 38725839 PMCID: PMC11079265 DOI: 10.3389/fcvm.2024.1372107] [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: 01/17/2024] [Accepted: 04/04/2024] [Indexed: 05/12/2024] Open
Abstract
Genetic research into atrial fibrillation (AF) and myocardial infarction (MI) has predominantly focused on comparing afflicted individuals with their healthy counterparts. However, this approach lacks granularity, thus overlooking subtleties within patient populations. In this study, we explore the distinction between AF and MI patients who experience only a single disease event and those experiencing recurrent events. Integrating hospital records, questionnaire data, clinical measurements, and genetic data from more than 500,000 HUNT and United Kingdom Biobank participants, we compare both clinical and genetic characteristics between the two groups using genome-wide association studies (GWAS) meta-analyses, phenome-wide association studies (PheWAS) analyses, and gene co-expression networks. We found that the two groups of patients differ in both clinical characteristics and genetic risks. More specifically, recurrent AF patients are significantly younger and have better baseline health, in terms of reduced cholesterol and blood pressure, than single AF patients. Also, the results of the GWAS meta-analysis indicate that recurrent AF patients seem to be at greater genetic risk for recurrent events. The PheWAS and gene co-expression network analyses highlight differences in the functions associated with the sets of single nucleotide polymorphisms (SNPs) and genes for the two groups. However, for MI patients, we found that those experiencing single events are significantly younger and have better baseline health than those with recurrent MI, yet they exhibit higher genetic risk. The GWAS meta-analysis mostly identifies genetic regions uniquely associated with single MI, and the PheWAS analysis and gene co-expression networks support the genetic differences between the single MI and recurrent MI groups. In conclusion, this work has identified novel genetic regions uniquely associated with single MI and related PheWAS analyses, as well as gene co-expression networks that support the genetic differences between the patient subgroups of single and recurrent occurrence for both MI and AF.
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Affiliation(s)
- Martina Hall
- Department of Biotechnology and Food Science, Norwegian University of Science and Technology, Trondheim, Norway
- K.G. Jebsen Center for Genetic Epidemiology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Anne Heidi Skogholt
- K.G. Jebsen Center for Genetic Epidemiology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Ida Surakka
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI, United States
| | - Haavard Dalen
- Clinic of Cardiology, St. Olavs University Hospital, Trondheim, Norway
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Medicine, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Eivind Almaas
- Department of Biotechnology and Food Science, Norwegian University of Science and Technology, Trondheim, Norway
- K.G. Jebsen Center for Genetic Epidemiology, Norwegian University of Science and Technology, Trondheim, Norway
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2
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The rs579459 ABO gene polymorphism and risk of incident cardiovascular events in obstructive sleep apnea: a pilot study. Sleep Breath 2022; 27:721-725. [DOI: 10.1007/s11325-022-02638-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 03/31/2022] [Accepted: 05/17/2022] [Indexed: 10/18/2022]
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3
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Cross B, Turner R, Pirmohamed M. Polygenic risk scores: An overview from bench to bedside for personalised medicine. Front Genet 2022; 13:1000667. [PMID: 36437929 PMCID: PMC9692112 DOI: 10.3389/fgene.2022.1000667] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 10/24/2022] [Indexed: 11/13/2022] Open
Abstract
Since the first polygenic risk score (PRS) in 2007, research in this area has progressed significantly. The increasing number of SNPs that have been identified by large scale GWAS analyses has fuelled the development of a myriad of PRSs for a wide variety of diseases and, more recently, to PRSs that potentially identify differential response to specific drugs. PRSs constitute a composite genomic biomarker and potential applications for PRSs in clinical practice encompass risk prediction and disease screening, early diagnosis, prognostication, and drug stratification to improve efficacy or reduce adverse drug reactions. Nevertheless, to our knowledge, no PRSs have yet been adopted into routine clinical practice. Beyond the technical considerations of PRS development, the major challenges that face PRSs include demonstrating clinical utility and circumnavigating the implementation of novel genomic technologies at scale into stretched healthcare systems. In this review, we discuss progress in developing disease susceptibility PRSs across multiple medical specialties, development of pharmacogenomic PRSs, and future directions for the field.
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Affiliation(s)
- Benjamin Cross
- The Wolfson Centre for Personalised Medicine, Institute of Systems, Molecular and Integrative Biology, Faculty of Health & Life Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Richard Turner
- The Wolfson Centre for Personalised Medicine, Institute of Systems, Molecular and Integrative Biology, Faculty of Health & Life Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Munir Pirmohamed
- The Wolfson Centre for Personalised Medicine, Institute of Systems, Molecular and Integrative Biology, Faculty of Health & Life Sciences, University of Liverpool, Liverpool, United Kingdom
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4
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Wahrenberg A, Kuja-Halkola R, Magnusson PKE, Häbel H, Warnqvist A, Hambraeus K, Jernberg T, Svensson P. Cardiovascular Family History Increases the Risk of Disease Recurrence After a First Myocardial Infarction. J Am Heart Assoc 2021; 10:e022264. [PMID: 34845931 PMCID: PMC9075368 DOI: 10.1161/jaha.121.022264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background Family history of atherosclerotic cardiovascular disease (ASCVD) is easily accessible and captures genetic cardiovascular risk, but its prognostic value in secondary prevention is unknown. Methods and Results We followed 25 615 patients registered in SWEDEHEART (Swedish Web‐System for Enhancement and Development of Evidence‐Based Care in Heart Disease Evaluated According to Recommended Therapies) from their 1‐year revisit after a first‐time myocardial infarction during 2005 to 2013, until December 31, 2018. Data on relatives, diagnoses and socioeconomics were extracted from national registers. The association between family history and recurrent ASCVD was studied with Cox proportional‐hazard regression, adjusting for risk factors and socioeconomics. A family history of ASCVD was defined as hospitalization due to myocardial infarction, angina with coronary revascularization, stroke, or cardiovascular death in ≥1 parent or full sibling, with early‐onset defined as disease‐onset before 55 years in men and 65 in women. The additional discriminatory value of family history to Thrombolysis in Myocardial Infarction Risk Score for Secondary Prevention was assessed with Harrell’s C‐index difference and reclassification was studied with continuous net reclassification improvement. Family history of early‐onset ASCVD in ≥1 first‐degree relative was present in 2.3% and was associated with recurrent ASCVD (hazard ratio [HR] 1.31; 95% CI, 1.17–1.47), fully adjusted for risk factors (HR, 1.22; 95% CI, 1.05–1.42). Early‐onset family history improved the discriminatory ability of the Thrombolysis in Myocardial Infarction Risk Score for Secondary Prevention, with Harrell’s C improving 0.003 points (95% CI, 0.001–0.005) from initial 0.587 (95% CI, 0.576–0.595) and improved reclassification (continuous net reclassification improvement 2.1%, P<0.001). Conclusions Family history of early‐onset ASCVD is associated with recurrent ASCVD after myocardial infarction, independently of traditional risk factors and improves secondary risk prediction. This may identify patients to target for intensified secondary prevention.
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Affiliation(s)
- Agnes Wahrenberg
- Division of Cardiology Department of Clinical Science and Education Karolinska InstitutetSödersjukhuset Stockholm Sweden
| | - Ralf Kuja-Halkola
- Department of Medical Epidemiology and Biostatistics Karolinska Institutet Stockholm Sweden
| | - Patrik K E Magnusson
- Department of Medical Epidemiology and Biostatistics Karolinska Institutet Stockholm Sweden
| | - Henrike Häbel
- Karolinska InstitutetInstitute of Environmental Medicine Stockholm Sweden
| | - Anna Warnqvist
- Karolinska InstitutetInstitute of Environmental Medicine Stockholm Sweden
| | | | - Tomas Jernberg
- Department of Clinical Sciences Karolinska InstitutetDanderyd University Hospital Stockholm Sweden
| | - Per Svensson
- Division of Cardiology Department of Clinical Science and Education Karolinska InstitutetSödersjukhuset Stockholm Sweden
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5
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Jiang J, Zheng Q, Han Y, Qiao S, Chen J, Yuan Z, Yu B, Ge L, Jia J, Gong Y, Wang Z, Chen D, Zhang Y, Huo Y. Genetic predisposition to coronary artery disease is predictive of recurrent events: a Chinese prospective cohort study. Hum Mol Genet 2021; 29:1044-1053. [PMID: 32065240 DOI: 10.1093/hmg/ddaa025] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Revised: 01/20/2020] [Accepted: 02/11/2020] [Indexed: 01/28/2023] Open
Abstract
Evidence of the effects of genetic risk score (GRS) on secondary prevention is scarce and mixed. We investigated whether coronary artery disease (CAD) susceptible loci can be used to predict the risk of major adverse cardiovascular events (MACEs) in a cohort with acute coronary syndromes (ACSs). A total of 1667 patients hospitalized with ACS were enrolled and prospectively followed for a median of 2 years. We constructed a weighted GRS comprising 79 CAD risk variants and investigated the association between GRS and MACE using a multivariable cox proportional hazard regression model. The incremental value of adding GRS into the prediction model was assessed by integrated discrimination improvement (IDI) and decision curve analysis (DCA). In the age- and sex-adjusted model, each increase in standard deviation in the GRS was associated with a 33% increased risk of MACE (hazard ratio: 1.33; 95% confidence interval: 1.10-1.61; P = 0.003), with this association not attenuating after further adjustment for traditional cardiovascular risk factors. The addition of GRS to a prediction model of seven clinical risk factors and EPICOR prognostic model slightly improved risk stratification for MACE as calculated by IDI (+1.7%, P = 0.006; +0.3%, P = 0.024, respectively). DCA demonstrated positive net benefits by adding GRS to other models. GRS was associated with MACE after multivariable adjustment in a cohort comprising Chinese ACS patients. Future studies are needed to validate our results and further evaluate the predictive value of GRS in secondary prevention.
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Affiliation(s)
- Jie Jiang
- Department of Cardiology, Peking University First Hospital, Beijing 100034, China
| | - Qiwen Zheng
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Yaling Han
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
| | - Shubin Qiao
- Department of Cardiology, Fuwai Hospital, Beijing 100037, China
| | - Jiyan Chen
- Department of Cardiology, Guangdong Provincial People's Hospital, Guangzhou 510080, China
| | - Zuyi Yuan
- Department of Cardiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China
| | - Bo Yu
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin 150001, China
| | - Lei Ge
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Jia Jia
- Department of Cardiology, Peking University First Hospital, Beijing 100034, China
| | - Yanjun Gong
- Department of Cardiology, Peking University First Hospital, Beijing 100034, China
| | - Zhi Wang
- Department of Cardiology, Peking University First Hospital, Beijing 100034, China
| | - Dafang Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Yan Zhang
- Department of Cardiology, Peking University First Hospital, Beijing 100034, China
| | - Yong Huo
- Department of Cardiology, Peking University First Hospital, Beijing 100034, China
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6
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Gray KJ, Kovacheva VP, Mirzakhani H, Bjonnes AC, Almoguera B, Wilson ML, Ingles SA, Lockwood CJ, Hakonarson H, McElrath TF, Murray JC, Norwitz ER, Karumanchi SA, Bateman BT, Keating BJ, Saxena R. Risk of pre-eclampsia in patients with a maternal genetic predisposition to common medical conditions: a case-control study. BJOG 2020; 128:55-65. [PMID: 32741103 DOI: 10.1111/1471-0528.16441] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/19/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To assess whether women with a genetic predisposition to medical conditions known to increase pre-eclampsia risk have an increased risk of pre-eclampsia in pregnancy. DESIGN Case-control study. SETTING AND POPULATION Pre-eclampsia cases (n = 498) and controls (n = 1864) in women of European ancestry from five US sites genotyped on a cardiovascular gene-centric array. METHODS Significant single-nucleotide polymorphisms (SNPs) from 21 traits in seven disease categories (cardiovascular, inflammatory/autoimmune, insulin resistance, liver, obesity, renal and thrombophilia) with published genome-wide association studies (GWAS) were used to create a genetic instrument for each trait. Multivariable logistic regression was used to test the association of each continuous scaled genetic instrument with pre-eclampsia. Odds of pre-eclampsia were compared across quartiles of the genetic instrument and evaluated for significance. MAIN OUTCOME MEASURES Genetic predisposition to medical conditions and relationship with pre-eclampsia. RESULTS An increasing burden of risk alleles for elevated diastolic blood pressure (DBP) and increased body mass index (BMI) were associated with an increased risk of pre-eclampsia (DBP, overall OR 1.11, 95% CI 1.01-1.21, P = 0.025; BMI, OR 1.10, 95% CI 1.00-1.20, P = 0.042), whereas alleles associated with elevated alkaline phosphatase (ALP) were protective (OR 0.89, 95% CI 0.82-0.97, P = 0.008), driven primarily by pleiotropic effects of variants in the FADS gene region. The effect of DBP genetic loci was even greater in early-onset pre-eclampsia cases (at <34 weeks of gestation, OR 1.30, 95% CI 1.08-1.56, P = 0.005). For other traits, there was no evidence of an association. CONCLUSIONS These results suggest that the underlying genetic architecture of pre-eclampsia may be shared with other disorders, specifically hypertension and obesity. TWEETABLE ABSTRACT A genetic predisposition to increased diastolic blood pressure and obesity increases the risk of pre-eclampsia.
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Affiliation(s)
- K J Gray
- Division of Maternal-Fetal Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.,Center for Genomic Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - V P Kovacheva
- Department of Anesthesiology, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - H Mirzakhani
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - A C Bjonnes
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - B Almoguera
- Center for Applied Genomics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - M L Wilson
- Department of Preventative Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - S A Ingles
- Department of Preventative Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - C J Lockwood
- Morsani College of Medicine, University of South Florida, Tampa, Florida, USA
| | - H Hakonarson
- Center for Applied Genomics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,Department of Pediatrics, Divisions of Human Genetics and Pulmonary Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - T F McElrath
- Division of Maternal-Fetal Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - J C Murray
- Department of Pediatrics, Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA
| | - E R Norwitz
- Department of Obstetrics & Gynecology, Tufts Medical Center, Boston, Massachusetts, USA
| | - S A Karumanchi
- Center for Vascular Biology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.,Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - B T Bateman
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - B J Keating
- Department of Surgery and Pediatrics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - R Saxena
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.,Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
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7
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Bing R, Loganath K, Adamson P, Newby D, Moss A. Non-invasive imaging of high-risk coronary plaque: the role of computed tomography and positron emission tomography. Br J Radiol 2020; 93:20190740. [PMID: 31821027 PMCID: PMC7465858 DOI: 10.1259/bjr.20190740] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 11/12/2019] [Accepted: 11/30/2019] [Indexed: 11/09/2022] Open
Abstract
Despite recent advances, cardiovascular disease remains the leading cause of death globally. As such, there is a need to optimise our current diagnostic and risk stratification pathways in order to better deliver individualised preventative therapies. Non-invasive imaging of coronary artery plaque can interrogate multiple aspects of coronary atherosclerotic disease, including plaque morphology, anatomy and flow. More recently, disease activity is being assessed to provide mechanistic insights into in vivo atherosclerosis biology. Molecular imaging using positron emission tomography is unique in this field, with the potential to identify specific biological processes using either bespoke or re-purposed radiotracers. This review provides an overview of non-invasive vulnerable plaque detection and molecular imaging of coronary atherosclerosis.
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Affiliation(s)
- Rong Bing
- British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
| | - Krithika Loganath
- Wessex Heart Centre, University Hospital of Southampton, Southampton, UK
| | | | - David Newby
- British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
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8
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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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9
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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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10
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Patel RS, Schmidt AF, Tragante V, McCubrey RO, Holmes MV, Howe LJ, Direk K, Åkerblom A, Leander K, Virani SS, Kaminski KA, Muehlschlegel JD, Dubé MP, Allayee H, Almgren P, Alver M, Baranova EV, Behlouli H, Boeckx B, Braund PS, Breitling LP, Delgado G, Duarte NE, Dufresne L, Eriksson N, Foco L, Gijsberts CM, Gong Y, Hartiala J, Heydarpour M, Hubacek JA, Kleber M, Kofink D, Kuukasjärvi P, Lee VV, Leiherer A, Lenzini PA, Levin D, Lyytikäinen LP, Martinelli N, Mons U, Nelson CP, Nikus K, Pilbrow AP, Ploski R, Sun YV, Tanck MWT, Tang WHW, Trompet S, van der Laan SW, van Setten J, Vilmundarson RO, Viviani Anselmi C, Vlachopoulou E, Boerwinkle E, Briguori C, Carlquist JF, Carruthers KF, Casu G, Deanfield J, Deloukas P, Dudbridge F, Fitzpatrick N, Gigante B, James S, Lokki ML, Lotufo PA, Marziliano N, Mordi IR, Muhlestein JB, Newton Cheh C, Pitha J, Saely CH, Samman-Tahhan A, Sandesara PB, Teren A, Timmis A, Van de Werf F, Wauters E, Wilde AAM, Ford I, Stott DJ, Algra A, Andreassi MG, Ardissino D, Arsenault BJ, Ballantyne CM, Bergmeijer TO, Bezzina CR, Body SC, Bogaty P, de Borst GJ, Brenner H, Burkhardt R, Carpeggiani C, Condorelli G, Cooper-DeHoff RM, Cresci S, de Faire U, Doughty RN, Drexel H, Engert JC, Fox KAA, Girelli D, Hagström E, Hazen SL, Held C, Hemingway H, Hoefer IE, Hovingh GK, Johnson JA, de Jong PA, Jukema JW, Kaczor MP, Kähönen M, Kettner J, Kiliszek M, Klungel OH, Lagerqvist B, Lambrechts D, Laurikka JO, Lehtimäki T, Lindholm D, Mahmoodi BK, Maitland-van der Zee AH, McPherson R, Melander O, Metspalu A, Pepinski W, Olivieri O, Opolski G, Palmer CN, Pasterkamp G, Pepine CJ, Pereira AC, Pilote L, Quyyumi AA, Richards AM, Sanak M, Scholz M, Siegbahn A, Sinisalo J, Smith JG, Spertus JA, Stewart AFR, Szczeklik W, Szpakowicz A, Ten Berg JM, Thanassoulis G, Thiery J, van der Graaf Y, Visseren FLJ, Waltenberger J, Van der Harst P, Tardif JC, Sattar N, Lang CC, Pare G, Brophy JM, Anderson JL, März W, Wallentin L, Cameron VA, Horne BD, Samani NJ, Hingorani AD, Asselbergs FW. Association of Chromosome 9p21 With Subsequent Coronary Heart Disease Events. CIRCULATION-GENOMIC AND PRECISION MEDICINE 2019; 12:e002471. [PMID: 30897348 PMCID: PMC6625876 DOI: 10.1161/circgen.119.002471] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Supplemental Digital Content is available in the text. Background: Genetic variation at chromosome 9p21 is a recognized risk factor for coronary heart disease (CHD). However, its effect on disease progression and subsequent events is unclear, raising questions about its value for stratification of residual risk. Methods: A variant at chromosome 9p21 (rs1333049) was tested for association with subsequent events during follow-up in 103 357 Europeans with established CHD at baseline from the GENIUS-CHD (Genetics of Subsequent Coronary Heart Disease) Consortium (73.1% male, mean age 62.9 years). The primary outcome, subsequent CHD death or myocardial infarction (CHD death/myocardial infarction), occurred in 13 040 of the 93 115 participants with available outcome data. Effect estimates were compared with case/control risk obtained from the CARDIoGRAMplusC4D consortium (Coronary Artery Disease Genome-wide Replication and Meta-analysis [CARDIoGRAM] plus The Coronary Artery Disease [C4D] Genetics) including 47 222 CHD cases and 122 264 controls free of CHD. Results: Meta-analyses revealed no significant association between chromosome 9p21 and the primary outcome of CHD death/myocardial infarction among those with established CHD at baseline (GENIUS-CHD odds ratio, 1.02; 95% CI, 0.99–1.05). This contrasted with a strong association in CARDIoGRAMPlusC4D odds ratio 1.20; 95% CI, 1.18–1.22; P for interaction <0.001 compared with the GENIUS-CHD estimate. Similarly, no clear associations were identified for additional subsequent outcomes, including all-cause death, although we found a modest positive association between chromosome 9p21 and subsequent revascularization (odds ratio, 1.07; 95% CI, 1.04–1.09). Conclusions: In contrast to studies comparing individuals with CHD to disease-free controls, we found no clear association between genetic variation at chromosome 9p21 and risk of subsequent acute CHD events when all individuals had CHD at baseline. However, the association with subsequent revascularization may support the postulated mechanism of chromosome 9p21 for promoting atheroma development.
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Affiliation(s)
- Riyaz S Patel
- Institute of Cardiovascular Science, Faculty of Population Health Science (R.S.P., A.F.S., L.J.H., K.D., J.D., A.D.H., F.W.A.).,Bart's Heart Centre, St Bartholomew's Hospital, London, United Kingdom (R.S.P., J.D., A. Timmis)
| | - Amand F Schmidt
- Institute of Cardiovascular Science, Faculty of Population Health Science (R.S.P., A.F.S., L.J.H., K.D., J.D., A.D.H., F.W.A.).,Division Heart and Lungs, Department of Cardiology (A.F.S., V.T. D.K., F.W.A.)
| | - Vinicius Tragante
- Division Heart and Lungs, Department of Cardiology (A.F.S., V.T. D.K., F.W.A.)
| | - Raymond O McCubrey
- Intermountain Heart Institute, Intermountain Medical Center, Salt Lake City, UT (R.O.M., J.F.C., J.B.M., J.L.A.)
| | - Michael V Holmes
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health (M.V.H.), University of Oxford, United Kingdom.,Medical Research Council Population Health Research Unit (M.V.H.), University of Oxford, United Kingdom.,National Institute for Health Research Oxford Biomedical Research Centre (M.V.H.), University of Oxford, United Kingdom
| | - Laurence J Howe
- Institute of Cardiovascular Science, Faculty of Population Health Science (R.S.P., A.F.S., L.J.H., K.D., J.D., A.D.H., F.W.A.)
| | - Kenan Direk
- Institute of Cardiovascular Science, Faculty of Population Health Science (R.S.P., A.F.S., L.J.H., K.D., J.D., A.D.H., F.W.A.)
| | - Axel Åkerblom
- Uppsala Clinical Research Center (A.A., N.E., S.J., E.H., C.H., B.L., D. Lindholm, A. Siegbahn, L.W.), Uppsala University, Sweden.,Department of Medical Sciences, Cardiology (A.A., E.H., C.H., D. Lindholm), Uppsala University, Sweden
| | - Karin Leander
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden (K.L., U.d.F.)
| | - Salim S Virani
- Section of Cardiology, Michael E. DeBakey Veterans Affairs Medical Center, Section of Cardiovascular Research, and Department of Medicine, Baylor College of Medicine, Houston, TX (S.S.V., C.M.B.)
| | - Karol A Kaminski
- Department of Population Medicine and Civilization Disease Prevention (K.A.K.).,Department of Cardiology (K.A.K., A. Szpakowicz)
| | | | | | - Hooman Allayee
- Departments of Preventive Medicine and Biochemistry and Molecular Medicine (H.A., J.H.), Keck School of Medicine of USC, Los Angeles, CA
| | - Peter Almgren
- Department of Clinical Sciences, Lund University, Malmö, Sweden (P.A., O.M.)
| | - Maris Alver
- Department of Biotechnology, Institute of Molecular and Cell Biology, University of Tartu, Estonia (M.A., A.M.)
| | - Ekaterina V Baranova
- Division of Pharmacoepidemiology and Clinical Pharmacology (E.V.B., O.H.K., A.H.M.-v.d.Z.), University Medical Center Utrecht, the Netherlands
| | - Hassan Behlouli
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre (H.B., L.D., L.P., J.M.B.)
| | - Bram Boeckx
- Laboratory for Translational Genetics, Department of Human Genetics (B.B., D. Lambrechts).,Laboratory for Translational Genetics, VIB Center for Cancer Biology, VIB, Belgium (B.B., D. Lambrechts)
| | - Peter S Braund
- Department of Cardiovascular Sciences (P.S.B., C.P.N., N.J.S.) and Department of Health Sciences, University of Leicester, United Kingdom.,National Institute of Health Research (NIHR) Leicester Biomedical Research Centre (P.S.B., C.P.N.), Glenfield Hospital, Leicester, United Kingdom
| | - Lutz P Breitling
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg (L.P.B., U.M., H.B.)
| | - Graciela Delgado
- Vth Department of Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany (G.D., M. Kleber, W.M.)
| | - Nubia E Duarte
- Heart Institute, University of Sao Paulo, Brazil (N.E.D., A.C.P.)
| | - Line Dufresne
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre (H.B., L.D., L.P., J.M.B.).,Preventive and Genomic Cardiology, McGill University Health Centre, Montreal, QC, Canada (L.D., J.C.E., G.T.)
| | - Niclas Eriksson
- Uppsala Clinical Research Center (A.A., N.E., S.J., E.H., C.H., B.L., D. Lindholm, A. Siegbahn, L.W.), Uppsala University, Sweden
| | - Luisa Foco
- Institute for Biomedicine, Eurac Research, Affiliated Institute of the University of Lübeck, Bolzano, Italy (L.F.)
| | | | - Yan Gong
- Department of Pharmacotherapy and Translational Research and Center for Pharmacogenomics (Y.G., R.M.C.-D., J.A.J.)
| | - Jaana Hartiala
- Departments of Preventive Medicine and Biochemistry and Molecular Medicine (H.A., J.H.), Keck School of Medicine of USC, Los Angeles, CA.,Institute for Genetic Medicine (J.H.), Keck School of Medicine of USC, Los Angeles, CA
| | - Mahyar Heydarpour
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital (M.H.).,Harvard Medical School, Boston, MA (J.D.M., M.H. S.C.B.)
| | - Jaroslav A Hubacek
- Centre for Experimental Medicine, Institut for Clinical and Experimental Medicine, Prague, Czech Republic (J.A.H., J.P.)
| | - Marcus Kleber
- Vth Department of Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany (G.D., M. Kleber, W.M.)
| | - Daniel Kofink
- Division Heart and Lungs, Department of Cardiology (A.F.S., V.T. D.K., F.W.A.)
| | | | - Vei-Vei Lee
- Department of Biostatistics and Epidemiology, Texas Heart Institute, Houston (V.-V.L.)
| | - Andreas Leiherer
- Vorarlberg Institute for Vascular Investigation and Treatment (VIVIT), Feldkirch, Austria (A.L., C.H.S., H.D.).,Private University of the Principality of Liechtenstein, Triesen, Liechtenstein (A.L., C.H.S., H.D.).,Medical Central Laboratories, Feldkirch, Austria (A.L.)
| | - Petra A Lenzini
- Department of Genetics, Statistical Genomics Division (P.A.L., S.C.)
| | - Daniel Levin
- Division of Molecular and Clinical Medicine, School of Medicine, University of Dundee, Scotland, United Kingdom (D. Levin, I.R.M., C.C.L.)
| | - Leo-Pekka Lyytikäinen
- Department of Clinical Chemistry (L.-P.L., T.L.).,Department of Clinical Chemistry, Fimlab Laboratories, Tampere, Finland (L.-P.L., T.L.)
| | - Nicola Martinelli
- Department of Medicine, University of Verona, Italy (N. Martinelli, D.G., O.O.)
| | - Ute Mons
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg (L.P.B., U.M., H.B.)
| | - Christopher P Nelson
- Department of Cardiovascular Sciences (P.S.B., C.P.N., N.J.S.) and Department of Health Sciences, University of Leicester, United Kingdom.,National Institute of Health Research (NIHR) Leicester Biomedical Research Centre (P.S.B., C.P.N.), Glenfield Hospital, Leicester, United Kingdom
| | - Kjell Nikus
- Department of Cardiology (K.N.).,Department of Cardiology, Heart Center (K.N.)
| | - Anna P Pilbrow
- The Christchurch Heart Institute, University of Otago Christchurch, New Zealand (A.P.B., A.M.R., V.A.C.)
| | | | - Yan V Sun
- Department of Epidemiology, Emory University Rollins School of Public Health (Y.V.S.).,Department of Biomedical Informatics (Y.V.S.)
| | | | - W H Wilson Tang
- Department of Cellular and Molecular Medicine, Lerner Research Institute (W.H.W.T., S.L.H.).,Department of Cardiovascular Medicine, Heart and Vascular Institute and Center for Clinical Genomics (W.H.W.T.)
| | - Stella Trompet
- Section of Gerontology and Geriatrics, Department of Internal Medicine (S.T.), Leiden University Medical Center.,Department of Cardiology (S.T., J.W.J.), Leiden University Medical Center
| | - Sander W van der Laan
- Laboratory of Clinical Chemistry and Hematology, Division Laboratories, Pharmacy, and Biomedical Genetics (S.W.v.d.L.)
| | - Jessica van Setten
- Durrer Centre of Cardiogenetic Research, ICIN-Netherlands Heart Institute, Netherlands (J.v.S., F.W.B.)
| | - Ragnar O Vilmundarson
- Ruddy Canadian Cardiovascular Genetics Centre (R.O.V., A.F.R.S.).,Department of Biochemistry, Microbiology and Immunology (R.O.V., A.F.R.S.)
| | - Chiara Viviani Anselmi
- Department of Cardiovascular Medicine, Humanitas Clinical and Research Center, Milan, Italy (C.V.A., G.C)
| | | | | | | | - John F Carlquist
- Intermountain Heart Institute, Intermountain Medical Center, Salt Lake City, UT (R.O.M., J.F.C., J.B.M., J.L.A.).,Cardiology Division, Department of Internal Medicine (J.F.C., J.B.M., J.L.A.)
| | | | - Gavino Casu
- Department of Cardiovascular Medicine, Humanitas Clinical and Research Center, Milan, Italy (C.V.A., G.C).,ATS Sardegna, ASL 3, Nuoro (G. Casu, N. Marziliano)
| | - John Deanfield
- Institute of Cardiovascular Science, Faculty of Population Health Science (R.S.P., A.F.S., L.J.H., K.D., J.D., A.D.H., F.W.A.).,Bart's Heart Centre, St Bartholomew's Hospital, London, United Kingdom (R.S.P., J.D., A. Timmis)
| | - Panos Deloukas
- William Harvey Research Institute, Barts and the London Medical School (P.D.), Queen Mary University of London.,Centre for Genomic Health (P.D.), Queen Mary University of London
| | - Frank Dudbridge
- BHF Cardiovascular Research Centre (F.D.), Glenfield Hospital, Leicester, United Kingdom
| | - Natalie Fitzpatrick
- Institute of Health Informatics, Faculty of Population Health Science, University College London, United Kingdom (N.F., C.H.S., A. Timmis, H.H., F.W.A.)
| | - Bruna Gigante
- Department of Clinical Chemistry and Hematology (B.G., I.E.H.)
| | - Stefan James
- Uppsala Clinical Research Center (A.A., N.E., S.J., E.H., C.H., B.L., D. Lindholm, A. Siegbahn, L.W.), Uppsala University, Sweden.,Department of Medical Sciences, Cardiology (S.J., B.L., L.W.), Uppsala University, Sweden
| | | | - Paulo A Lotufo
- Centro de Pesquisa Clinica, Hospital Universitario, Universidade de Sao Paulo, Brazil (P.A.L.)
| | | | - Ify R Mordi
- Division of Molecular and Clinical Medicine, School of Medicine, University of Dundee, Scotland, United Kingdom (D. Levin, I.R.M., C.C.L.)
| | - Joseph B Muhlestein
- Intermountain Heart Institute, Intermountain Medical Center, Salt Lake City, UT (R.O.M., J.F.C., J.B.M., J.L.A.).,Cardiology Division, Department of Internal Medicine (J.F.C., J.B.M., J.L.A.)
| | - Chris Newton Cheh
- Cardiovascular Research Center and Center for Human Genetic Research, Massachusetts General Hospital, Boston and Program in Medical and Population Genetics, Broad Institute, Cambridge, MA (C.N.C.)
| | - Jan Pitha
- Centre for Experimental Medicine, Institut for Clinical and Experimental Medicine, Prague, Czech Republic (J.A.H., J.P.)
| | - Christoph H Saely
- Institute of Health Informatics, Faculty of Population Health Science, University College London, United Kingdom (N.F., C.H.S., A. Timmis, H.H., F.W.A.).,Vorarlberg Institute for Vascular Investigation and Treatment (VIVIT), Feldkirch, Austria (A.L., C.H.S., H.D.).,Private University of the Principality of Liechtenstein, Triesen, Liechtenstein (A.L., C.H.S., H.D.)
| | - Ayman Samman-Tahhan
- Division of Cardiology, Department of Medicine, Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, GA (A.S.-T., P.B.S., A.A.Q.)
| | - Pratik B Sandesara
- Division of Cardiology, Department of Medicine, Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, GA (A.S.-T., P.B.S., A.A.Q.)
| | - Andrej Teren
- Department of Medicine and Cardiology, Academic Teaching Hospital Feldkirch, Austria. Heart Center Leipzig (A. Teren).,LIFE Research Center for Civilization Diseases (A. Teren, R.B., M. Scholz, J.T.)
| | - Adam Timmis
- Institute of Health Informatics, Faculty of Population Health Science, University College London, United Kingdom (N.F., C.H.S., A. Timmis, H.H., F.W.A.).,Bart's Heart Centre, St Bartholomew's Hospital, London, United Kingdom (R.S.P., J.D., A. Timmis)
| | - Frans Van de Werf
- Departement of Cardiovascular Sciences, KU Leuven, Belgium (F.V.d.W.)
| | - Els Wauters
- Respiratory Oncology Unit, Department of Respiratory Medicine, University Hospitals KU Leuven, Belgium (E.W.)
| | - Arthur A M Wilde
- AMC Heart Center (A.A.M.W., C.R.B.).,Princess Al-Jawhara Al-Brahim Centre of Excellence in Research of Hereditary Disorders, Jeddah, Saudi Arabia (A.A.M.W.)
| | - Ian Ford
- Robertson Center for Biostatistics (I.F.)
| | - David J Stott
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, United Kingdom (D.J.S., N.S.)
| | - Ale Algra
- Department of Neurology and Neurosurgery, Brain Centre Rudolf Magnus and Julius Center for Health Sciences and Primary Care (A. Algra), University Medical Center Utrecht, the Netherlands
| | | | - Diego Ardissino
- Cardiology Department, Parma University Hospital, Italy (D.A.)
| | - Benoit J Arsenault
- Centre de recherche de l'Institut Universitaire de cardiologie et de pneumologie de Québec (B.J.A.).,Department of Medicine, Faculty of Medicine, Université Laval, Canada (B.J.A.)
| | - Christie M Ballantyne
- Section of Cardiology, Michael E. DeBakey Veterans Affairs Medical Center, Section of Cardiovascular Research, and Department of Medicine, Baylor College of Medicine, Houston, TX (S.S.V., C.M.B.)
| | - Thomas O Bergmeijer
- St. Antonius Hospital, Department of Cardiology, Nieuwegein, the Netherlands (T.O.B., B.K.M., J.M.t.B.)
| | | | - Simon C Body
- Harvard Medical School, Boston, MA (J.D.M., M.H. S.C.B.).,Department of Anesthesia, Pain and Critical Care, Beth Israel Deaconess Medical Center, Boston, MA (S.C.B.)
| | - Peter Bogaty
- Service de cardiologie, Département multidisciplinaire de cardiologie, Instituteitut universitaire de cardiologie et de pneumologie de Québec, Canada (P.B.).,Unité d'évaluation cardiovasculaire, Institut national d'excellence en santé et en services sociaux (INESSS), Montreal Canada (P.B.).,Instituteitut universitaire de cardiologie et de pneumologie de Québec, Laval University, Québec City, Canada (P.B.)
| | - Gert J de Borst
- Department of Vascular Surgery, University Medical Center Utrecht, University Utrecht, the Netherlands (G.J.d.B.)
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg (L.P.B., U.M., H.B.)
| | - Ralph Burkhardt
- LIFE Research Center for Civilization Diseases (A. Teren, R.B., M. Scholz, J.T.).,Institute of Clinical Chemistry and Laboratory Medicine, University Hospital Regensburg, Germany (R.B.)
| | | | - Gianluigi Condorelli
- Department of Biomedical Sciences, Humanitas University, Milan, Italy (G. Condorelli)
| | - Rhonda M Cooper-DeHoff
- Department of Pharmacotherapy and Translational Research and Center for Pharmacogenomics (Y.G., R.M.C.-D., J.A.J.)
| | - Sharon Cresci
- Department of Genetics, Statistical Genomics Division (P.A.L., S.C.).,Department of Medicine, Cardiovascular Division Washington University School of Medicine, St Louis, MO (S.C.)
| | - Ulf de Faire
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden (K.L., U.d.F.)
| | - Robert N Doughty
- Heart Health Research Group, University of Auckland, New Zealand (R.N.D.)
| | - Heinz Drexel
- Vorarlberg Institute for Vascular Investigation and Treatment (VIVIT), Feldkirch, Austria (A.L., C.H.S., H.D.).,Private University of the Principality of Liechtenstein, Triesen, Liechtenstein (A.L., C.H.S., H.D.).,Drexel University College of Medicine, Philadelphia, PA (H.D.)
| | - James C Engert
- Research Institute of the McGill University Health Centre (J.C.E.).,Division of Cardiology, Department of Medicine, Royal Victoria Hospital (J.C.E., G.T.).,Preventive and Genomic Cardiology, McGill University Health Centre, Montreal, QC, Canada (L.D., J.C.E., G.T.)
| | - Keith A A Fox
- Emeritus Professor of Cardiology (K.A.A.F.), University of Edinburgh
| | - Domenico Girelli
- Department of Medicine, University of Verona, Italy (N. Martinelli, D.G., O.O.)
| | - Emil Hagström
- Uppsala Clinical Research Center (A.A., N.E., S.J., E.H., C.H., B.L., D. Lindholm, A. Siegbahn, L.W.), Uppsala University, Sweden.,Department of Medical Sciences, Cardiology (A.A., E.H., C.H., D. Lindholm), Uppsala University, Sweden
| | - Stanley L Hazen
- Department of Cellular and Molecular Medicine, Lerner Research Institute (W.H.W.T., S.L.H.).,Department of Cardiovascular Medicine, Heart and Vascular Institute and Center for Microbiome and Human Health, Cleveland Clinic, OH (S.L.H.)
| | - Claes Held
- Uppsala Clinical Research Center (A.A., N.E., S.J., E.H., C.H., B.L., D. Lindholm, A. Siegbahn, L.W.), Uppsala University, Sweden.,Department of Medical Sciences, Cardiology (A.A., E.H., C.H., D. Lindholm), Uppsala University, Sweden
| | - Harry Hemingway
- Institute of Health Informatics, Faculty of Population Health Science, University College London, United Kingdom (N.F., C.H.S., A. Timmis, H.H., F.W.A.)
| | - Imo E Hoefer
- Department of Clinical Chemistry and Hematology (B.G., I.E.H.)
| | - G Kees Hovingh
- Department of Vascular Medicine, Academic Medical Center, Amsterdam, the Netherlands (G.K.H.)
| | - Julie A Johnson
- Department of Pharmacotherapy and Translational Research and Center for Pharmacogenomics (Y.G., R.M.C.-D., J.A.J.).,Division of Cardiovascular Medicine, College of Medicine, University of Florida (J.A.J., C.J.P.)
| | - Pim A de Jong
- Department of Radiology (P.A.d.J.), University Medical Center Utrecht, the Netherlands
| | - J Wouter Jukema
- Department of Cardiology (S.T., J.W.J.), Leiden University Medical Center.,Einthoven Laboratory for Experimental Vascular Medicine, LUMC, Leiden (J.W.J.).,Interuniversity Cardiology Institute of the Netherlands, Utrecht, the Netherlands (J.W.J.)
| | - Marcin P Kaczor
- Department of Internal Medicine, Jagiellonian University Medical College, Kraków, Poland (M.P.K., M. Sanak, W.S.)
| | - Mika Kähönen
- Department of Clinical Physiology (M. Kähönen).,Department of Clinical Physiology (M. Kähönen)
| | - Jiri Kettner
- Cardiology Centre, Institute for Clinical and Experimental Medicine, Prague, Czech Republic (J.K.)
| | - Marek Kiliszek
- Department of Cardiology and Internal Diseases, Military Institute of Medicine, Warsaw, Poland (M. Kiliszek)
| | - Olaf H Klungel
- Division of Pharmacoepidemiology and Clinical Pharmacology (E.V.B., O.H.K., A.H.M.-v.d.Z.), University Medical Center Utrecht, the Netherlands
| | - Bo Lagerqvist
- Uppsala Clinical Research Center (A.A., N.E., S.J., E.H., C.H., B.L., D. Lindholm, A. Siegbahn, L.W.), Uppsala University, Sweden.,Department of Medical Sciences, Cardiology (S.J., B.L., L.W.), Uppsala University, Sweden
| | - Diether Lambrechts
- Laboratory for Translational Genetics, Department of Human Genetics (B.B., D. Lambrechts).,Laboratory for Translational Genetics, VIB Center for Cancer Biology, VIB, Belgium (B.B., D. Lambrechts)
| | - Jari O Laurikka
- Department of Cardio-Thoracic Surgery, Finnish Cardiovascular Research Center, Faculty of Medicine and Life Sciences, University of Tampere (J.O.L.).,Department of Cardio-Thoracic Surgery, Heart Center, Tampere University Hospital, Finland (J.O.L)
| | - Terho Lehtimäki
- Department of Clinical Chemistry (L.-P.L., T.L.).,Department of Clinical Chemistry, Fimlab Laboratories, Tampere, Finland (L.-P.L., T.L.)
| | - Daniel Lindholm
- Uppsala Clinical Research Center (A.A., N.E., S.J., E.H., C.H., B.L., D. Lindholm, A. Siegbahn, L.W.), Uppsala University, Sweden.,Department of Medical Sciences, Cardiology (A.A., E.H., C.H., D. Lindholm), Uppsala University, Sweden
| | - Bakhtawar K Mahmoodi
- St. Antonius Hospital, Department of Cardiology, Nieuwegein, the Netherlands (T.O.B., B.K.M., J.M.t.B.)
| | - Anke H Maitland-van der Zee
- Division of Pharmacoepidemiology and Clinical Pharmacology (E.V.B., O.H.K., A.H.M.-v.d.Z.), University Medical Center Utrecht, the Netherlands.,Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, Department of Respiratory Medicine, Academic Medical Center, University of Amsterdam, the Netherlands (A.H.M.-v.d.Z.)
| | - Ruth McPherson
- University of Ottawa Heart Institute (R.M.).,Departments of Medicine and Biochemistry, Microbiology and Immunology, University of Ottawa, ON, Canada (R.M.)
| | - Olle Melander
- Department of Clinical Sciences, Lund University, Malmö, Sweden (P.A., O.M.).,Department of Internal Medicine, Skåne University Hospital, Malmö, Sweden (O.M.)
| | - Andres Metspalu
- Estonian Genome Center, Institute of Genomics (A.M.).,Department of Biotechnology, Institute of Molecular and Cell Biology, University of Tartu, Estonia (M.A., A.M.)
| | - Witold Pepinski
- Department of Forensic Medicine, Medical University of Bialystok, Poland (W.P., G.T.)
| | - Oliviero Olivieri
- Department of Medicine, University of Verona, Italy (N. Martinelli, D.G., O.O.)
| | - Grzegorz Opolski
- Department of Cardiology, Medical University of Warsaw, Poland (G.O.)
| | - Colin N Palmer
- Pat Macpherson Centre for Pharmacogenetics and Pharmacogenomics, Division of Molecular and Clinical Medicine, Ninewells Hospital and Medical School, Dundee (C.N.P.)
| | - Gerard Pasterkamp
- Department of Clinical Chemistry, UMC Utrecht, Netherlands (G. Pasterkamp)
| | - Carl J Pepine
- Division of Cardiovascular Medicine, College of Medicine, University of Florida (J.A.J., C.J.P.)
| | | | - Louise Pilote
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre (H.B., L.D., L.P., J.M.B.).,Department of Medicine (L.P., J.M.B.)
| | - Arshed A Quyyumi
- Division of Cardiology, Department of Medicine, Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, GA (A.S.-T., P.B.S., A.A.Q.)
| | - A Mark Richards
- The Christchurch Heart Institute, University of Otago Christchurch, New Zealand (A.P.B., A.M.R., V.A.C.).,Cardiovascular Research Institute, National University of Singapore (A.M.R.)
| | - Marek Sanak
- Department of Internal Medicine, Jagiellonian University Medical College, Kraków, Poland (M.P.K., M. Sanak, W.S.)
| | - Markus Scholz
- LIFE Research Center for Civilization Diseases (A. Teren, R.B., M. Scholz, J.T.).,Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Germany (M. Scholz)
| | - Agneta Siegbahn
- Uppsala Clinical Research Center (A.A., N.E., S.J., E.H., C.H., B.L., D. Lindholm, A. Siegbahn, L.W.), Uppsala University, Sweden.,Department of Medical Sciences, Clinical Chemistry (A. Siegbahn), Uppsala University, Sweden
| | - Juha Sinisalo
- Heart and Lung Center, Helsinki University Hospital University of Helsinki, Finland (J.S.)
| | - J Gustav Smith
- Department of Cardiology, Clinical Sciences, Lund University and Skåne University Hospital (J.G.S.), Lund University, Lund, Sweden.,Wallenberg Center for Molecular Medicine (J.G.S.), Lund University, Lund, Sweden.,Lund University Diabetes Center (J.G.S.), Lund University, Lund, Sweden
| | - John A Spertus
- Saint Luke's Mid America Heart Institute and the University of Missouri-Kansas City and Saint Luke's Health System, Kansas City, MO (J.A.S.)
| | - Alexandre F R Stewart
- Ruddy Canadian Cardiovascular Genetics Centre (R.O.V., A.F.R.S.).,Department of Biochemistry, Microbiology and Immunology (R.O.V., A.F.R.S.)
| | - Wojciech Szczeklik
- Department of Internal Medicine, Jagiellonian University Medical College, Kraków, Poland (M.P.K., M. Sanak, W.S.)
| | | | - Jurriën M Ten Berg
- St. Antonius Hospital, Department of Cardiology, Nieuwegein, the Netherlands (T.O.B., B.K.M., J.M.t.B.)
| | - George Thanassoulis
- Department of Forensic Medicine, Medical University of Bialystok, Poland (W.P., G.T.).,Division of Cardiology, Department of Medicine, Royal Victoria Hospital (J.C.E., G.T.).,Preventive and Genomic Cardiology, McGill University Health Centre, Montreal, QC, Canada (L.D., J.C.E., G.T.)
| | - Joachim Thiery
- LIFE Research Center for Civilization Diseases (A. Teren, R.B., M. Scholz, J.T.).,Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University Hospital, Leipzig (J.T.)
| | - Yolanda van der Graaf
- Julius Center for Health Sciences and Primary Care (Y.v.d.G.), University Medical Center Utrecht, the Netherlands
| | - Frank L J Visseren
- Department of Vascular Medicine, University Medical Center Utrecht and Utrecht University, the Netherlands (F.L.J.V.)
| | | | | | - Pim Van der Harst
- CARDIoGRAMPlusC4D. University of Groningen, University Medical Center, Groningen, Netherlands (P.V.d.H.)
| | | | - Naveed Sattar
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, United Kingdom (D.J.S., N.S.)
| | - Chim C Lang
- Division of Molecular and Clinical Medicine, School of Medicine, University of Dundee, Scotland, United Kingdom (D. Levin, I.R.M., C.C.L.)
| | - Guillaume Pare
- Department of Pathology and Molecular Medicine, McMaster University (G. Pare).,Population Health Research Institute, Hamilton, ON, Canada (G. Pare)
| | - James M Brophy
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre (H.B., L.D., L.P., J.M.B.).,Department of Medicine (L.P., J.M.B.)
| | - Jeffrey L Anderson
- Intermountain Heart Institute, Intermountain Medical Center, Salt Lake City, UT (R.O.M., J.F.C., J.B.M., J.L.A.).,Cardiology Division, Department of Internal Medicine (J.F.C., J.B.M., J.L.A.)
| | - Winfried März
- Vth Department of Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany (G.D., M. Kleber, W.M.).,Synlab Academy, Synlab Holding Deutschland GmbH, Mannheim, Germany (W.M.).,Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Austria (W.M.)
| | - Lars Wallentin
- Uppsala Clinical Research Center (A.A., N.E., S.J., E.H., C.H., B.L., D. Lindholm, A. Siegbahn, L.W.), Uppsala University, Sweden.,Department of Medical Sciences, Cardiology (S.J., B.L., L.W.), Uppsala University, Sweden
| | - Vicky A Cameron
- The Christchurch Heart Institute, University of Otago Christchurch, New Zealand (A.P.B., A.M.R., V.A.C.)
| | - Benjamin D Horne
- Laboratory of Experimental Cardiology (C.M.G., B.D.H.).,Department of Biomedical Informatics, University of Utah, Salt Lake City (B.D.H.)
| | - Nilesh J Samani
- Department of Cardiovascular Sciences (P.S.B., C.P.N., N.J.S.) and Department of Health Sciences, University of Leicester, United Kingdom
| | - Aroon D Hingorani
- Institute of Cardiovascular Science, Faculty of Population Health Science (R.S.P., A.F.S., L.J.H., K.D., J.D., A.D.H., F.W.A.)
| | - Folkert W Asselbergs
- Institute of Cardiovascular Science, Faculty of Population Health Science (R.S.P., A.F.S., L.J.H., K.D., J.D., A.D.H., F.W.A.).,Institute of Health Informatics, Faculty of Population Health Science, University College London, United Kingdom (N.F., C.H.S., A. Timmis, H.H., F.W.A.).,Division Heart and Lungs, Department of Cardiology (A.F.S., V.T. D.K., F.W.A.).,Durrer Centre of Cardiogenetic Research, ICIN-Netherlands Heart Institute, Netherlands (J.v.S., F.W.B.)
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Vershinina EO, Repin AN. Predictors of long term adverse events after scheduled endovascular coronary interventions. КАРДИОВАСКУЛЯРНАЯ ТЕРАПИЯ И ПРОФИЛАКТИКА 2018. [DOI: 10.15829/1728-8800-2018-4-46-52] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Affiliation(s)
- E. O. Vershinina
- SRI of Cardiology “Tomsk National Research Medical Center of RAS”
| | - A. N. Repin
- SRI of Cardiology “Tomsk National Research Medical Center of RAS”
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12
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Coverstone ED, Bach RG, Chen L, Bierut LJ, Li AY, Lenzini PA, O'Neill HC, Spertus JA, Sucharov CC, Stitzel JA, Schilling JD, Cresci S. A novel genetic marker of decreased inflammation and improved survival after acute myocardial infarction. Basic Res Cardiol 2018; 113:38. [PMID: 30097758 PMCID: PMC6292447 DOI: 10.1007/s00395-018-0697-7] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Accepted: 08/06/2018] [Indexed: 10/28/2022]
Abstract
The CHRNA5 gene encodes a neurotransmitter receptor subunit involved in multiple processes, including cholinergic autonomic nerve activity and inflammation. Common variants in CHRNA5 have been linked with atherosclerotic cardiovascular disease. Association of variation in CHRNA5 and specific haplotypes with cardiovascular outcomes has not been described. The aim of this study was to examine the association of CHRNA5 haplotypes with gene expression and mortality among patients with acute myocardial infarction (AMI) and explore potential mechanisms of this association. Patients (N = 2054) hospitalized with AMI were genotyped for two common variants in CHRNA5. Proportional hazard models were used to estimate independent association of CHRNA5 haplotype with 1-year mortality. Both individual variants were associated with mortality (p = 0.0096 and 0.0004, respectively) and were in tight LD (D' = 0.99). One haplotype, HAP3, was associated with decreased mortality one year after AMI (adjusted HR = 0.42, 95% CI 0.26, 0.68; p = 0.0004). This association was validated in an independent cohort (N = 637) of post-MI patients (adjusted HR = 0.23, 95% CI 0.07, 0.79; p = 0.019). Differences in CHRNA5 expression by haplotype were investigated in human heart samples (n = 28). Compared with non-carriers, HAP3 carriers had threefold lower cardiac CHRNA5 mRNA expression (p = 0.023). Circulating levels of the inflammatory marker hsCRP were significantly lower in HAP3 carriers versus non-carriers (3.43 ± 4.2 versus 3.91 ± 5.1; p = 0.0379). Activation of the inflammasome, an important inflammatory complex involved in cardiovascular disease that is necessary for release of the pro-inflammatory cytokine IL-1 β, was assessed in bone marrow-derived macrophages (BMDM) from CHRNA5 knockout mice and wild-type controls. In BMDM from CHRNA5 knockout mice, IL-1β secretion was reduced by 50% compared to wild-type controls (p = 0.004). Therefore, a common haplotype of CHRNA5 that results in reduced cardiac expression of CHRNA5 and attenuated macrophage inflammasome activation is associated with lower mortality after AMI. These results implicate CHRNA5 and the cholinergic anti-inflammatory pathway in survival following AMI.
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Affiliation(s)
- Edward D Coverstone
- Cardiovascular Division, Department of Medicine, Washington University School of Medicine, 660 S. Euclid Ave., Campus, Box 8086, Saint Louis, MO, 63110, USA
| | - Richard G Bach
- Cardiovascular Division, Department of Medicine, Washington University School of Medicine, 660 S. Euclid Ave., Campus, Box 8086, Saint Louis, MO, 63110, USA
| | - LiShiun Chen
- Department of Psychiatry, Washington University School of Medicine, Saint Louis, MO, USA
| | - Laura J Bierut
- Department of Psychiatry, Washington University School of Medicine, Saint Louis, MO, USA
| | - Allie Y Li
- Cardiovascular Division, Department of Medicine, Washington University School of Medicine, 660 S. Euclid Ave., Campus, Box 8086, Saint Louis, MO, 63110, USA
| | - Petra A Lenzini
- Statistical Genomics Division, Department of Genetics, Washington University School of Medicine, Saint Louis, MO, USA
| | - Heidi C O'Neill
- Institute for Behavioral Genetics, University of Colorado, Boulder, USA
| | - John A Spertus
- Saint Luke's Mid America Heart Institute and the University of Missouri-Kansas City, Kansas City, MO, USA
| | - Carmen C Sucharov
- Cardiology Division, Department of Medicine, University of Colorado Denver, Aurora, USA
| | - Jerry A Stitzel
- Institute for Behavioral Genetics, University of Colorado, Boulder, USA
| | - Joel D Schilling
- Cardiovascular Division, Department of Medicine, Washington University School of Medicine, 660 S. Euclid Ave., Campus, Box 8086, Saint Louis, MO, 63110, USA
- Department of Pathology and Immunology, Washington University School of Medicine, Saint Louis, MO, USA
| | - Sharon Cresci
- Cardiovascular Division, Department of Medicine, Washington University School of Medicine, 660 S. Euclid Ave., Campus, Box 8086, Saint Louis, MO, 63110, USA.
- Department of Genetics, Washington University School of Medicine, Saint Louis, MO, USA.
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13
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Tricoci P, Neely M, Whitley MJ, Edelstein LC, Simon LM, Shaw C, Fortina P, Moliterno DJ, Armstrong PW, Aylward P, White H, Van de Werf F, Jennings LK, Wallentin L, Held C, Harrington RA, Mahaffey KW, Bray PF. Effects of genetic variation in protease activated receptor 4 after an acute coronary syndrome: Analysis from the TRACER trial. Blood Cells Mol Dis 2018; 72:37-43. [PMID: 30055940 DOI: 10.1016/j.bcmd.2018.07.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 07/20/2018] [Indexed: 01/05/2023]
Abstract
Variation in platelet response to thrombin may affect the safety and efficacy of PAR antagonism. The Thr120 variant of the common single nucleotide polymorphism (SNP) rs773902 in the protease-activated receptor (PAR) 4 gene is associated with higher platelet aggregation compared to the Ala120 variant. We investigated the relationship between the rs773902 SNP with major bleeding and ischemic events, safety, and efficacy of PAR1 inhibition in 6177 NSTE ACS patients in the TRACER trial. There was a lower rate of GUSTO moderate/severe bleeding in patients with the Thr120 variant. The difference was driven by a lower rate in the smaller homozygous group (recessive model, HR 0.13 [0.02-0.92] P = 0.042). No significant differences were observed in the ischemic outcomes. The excess in bleeding observed with PAR1 inhibition was attenuated in patients with the Thr120 variant, but the interactions were not statistically significant. In summary, lower major bleeding rates were observed in the overall TRACER cohort with the hyperreactive PAR4 Thr120 variant. The increase in bleeding with vorapaxar was attenuated with the Thr120 variant, but we could not demonstrate an interaction with PAR1 inhibition. These findings warrant further exploration, including those of African ancestry where the A allele (Thr120) frequency is ~65%.
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Affiliation(s)
| | - Megan Neely
- Duke Clinical Research Institute, Duke University, Durham, NC, USA
| | - Michael J Whitley
- The Cardeza Foundation for Hematologic Research and the Department of Medicine, Thomas Jefferson University, Sidney Kimmel Medical College, Philadelphia, PA, USA
| | - Leonard C Edelstein
- The Cardeza Foundation for Hematologic Research and the Department of Medicine, Thomas Jefferson University, Sidney Kimmel Medical College, Philadelphia, PA, USA
| | - Lukas M Simon
- Department of Human & Molecular Genetics, Baylor College of Medicine, Houston, TX, USA
| | - Chad Shaw
- Department of Human & Molecular Genetics, Baylor College of Medicine, Houston, TX, USA; Department of Statistics, Rice University, Houston, TX, USA
| | - Paolo Fortina
- Cancer Genomics and Bioinformatics Laboratory, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, USA
| | - David J Moliterno
- Gill Heart Institute and Division of Cardiovascular Medicine, University of Kentucky, Lexington, KY, USA
| | | | - Philip Aylward
- Division of Medicine, Cardiac & Critical Care Services, Flinders Medical Centre, Bedford Park, South Australia, Australia
| | - Harvey White
- Green Lane Cardiovascular Service, Auckland City Hospital, Auckland, New Zealand
| | - Frans Van de Werf
- Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Lisa K Jennings
- CirQuest Labs, LLC, and University of Tennessee Health Science Center, Memphis, TN, USA
| | - Lars Wallentin
- Department of Medical Sciences, Uppsala Clinical Research Center, Uppsala, Sweden
| | - Claes Held
- Department of Medical Sciences, Uppsala Clinical Research Center, Uppsala, Sweden
| | | | | | - Paul F Bray
- Division of Hematology and Hematologic Malignancies in the Department of Internal Medicine and the Molecular Medicine Program, University of Utah, Salt Lake City, UT, USA.
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14
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Toapanta Gaibor NG, González-Roncero FM, Cintra Cabrera M, Suñer Poblet M, Bernal Blanco G, Suarez Benjumea A, Pérez-Valdivia MA, Egea-Guerrero JJ, Rocha Castilla JL, Gentil Govantes MA. Survival and Evolution of Renal Function in Kidney Transplant Recipients From Type II Asystolic Donations: A Single-center Experience. Transplant Proc 2018; 50:565-568. [PMID: 29579853 DOI: 10.1016/j.transproceed.2017.11.059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Revised: 10/19/2017] [Accepted: 11/11/2017] [Indexed: 10/17/2022]
Abstract
BACKGROUND In recent years, stagnation in the number of kidneys from after brain-dead donors (DBD) has stimulated the use of non-heart beating donors (NHBDs). Herein we present our 5-year experience with type II Maastricht NHBDs in renal transplantation. METHODS All patients (n = 50) in this study received type II Maastricht NHBD kidneys (March 2012 to February 2017), with a median follow-up of 33 months. RESULTS Mean donor age was 39 ± 12 years, mean creatinine 1.24 ± 0.2 mg/dL, and the most frequently observed blood group (donors and recipients) was type A (64%). Recipients were slightly younger (51 ± 11 years old), with mean time on dialysis of 30 ± 24 months. Almost all were primary transplants. Pre-transplant panel-reactive antibodies (PRA) were <25%; initial immunosuppression was thymoglobulin, corticosteroids, mycophenolate mofetil, and delayed introduction of tacrolimus. Six percent were nonfunctioning kidneys; 79.6% presented with delayed renal function (mean duration 14 ± 9 days). Acute rejection was seen in 6% of patients. Mean creatinine at month 3 was 1.7 ± 0.8 mg/dL, and 1.5 ± 0.8 mg/dL in the first year. The last available mean creatinine was 1.54 ± 0.7 mg/dL. Proteinuria in the third month, first year, and third year was 0.70, 0.41, and 0.26 g/d, respectively. Recipient survival at the first, third, and fifth year was 100%, 100%, and 86%, and when graft-censored for death was 94%, 91%, and 91%, respectively. The incidence of acute rejection during first year was 6%, and 2% in the second year. Exitus incidence was 4% and cytomegalovirus infection was 21.3%. BK viremia between 1000 and 10,000 copies/mL was seen in 4.3%, and reached >10,000 copies/mL in 2.1%. CONCLUSIONS Type II NHBD has shown limited frequency of nonfunctioning kidney and high functional delay. The results in survival and renal function are very acceptable, comparable with levels seen in donation after brain death.
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Affiliation(s)
- N G Toapanta Gaibor
- Department of Nephrology, Virgen del Rocío University Hospital, Seville, Spain.
| | | | - M Cintra Cabrera
- Department of Nephrology, Virgen del Rocío University Hospital, Seville, Spain
| | - M Suñer Poblet
- Department of Nephrology, Virgen del Rocío University Hospital, Seville, Spain
| | - G Bernal Blanco
- Department of Nephrology, Virgen del Rocío University Hospital, Seville, Spain
| | - A Suarez Benjumea
- Department of Nephrology, Virgen del Rocío University Hospital, Seville, Spain
| | - M A Pérez-Valdivia
- Department of Nephrology, Virgen del Rocío University Hospital, Seville, Spain
| | - J J Egea-Guerrero
- Department of Nephrology, Virgen del Rocío University Hospital, Seville, Spain
| | - J L Rocha Castilla
- Department of Nephrology, Virgen del Rocío University Hospital, Seville, Spain
| | - M A Gentil Govantes
- Department of Nephrology, Virgen del Rocío University Hospital, Seville, Spain
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15
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Labos C, Thanassoulis G. Genetic Risk Prediction for Primary and Secondary Prevention of Atherosclerotic Cardiovascular Disease: an Update. Curr Cardiol Rep 2018; 20:36. [PMID: 29574623 DOI: 10.1007/s11886-018-0980-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
PURPOSE OF REVIEW This review aims to summarize the research on genetic risk scores and their ability to improve risk prediction in both a primary and a secondary prevention population. RECENT FINDINGS Several groups have examined the role of genetic scores in different patient populations. Recent studies have capitalized on the growing number of identified genetic variants to construct polygenic risk scores that include hundreds and sometimes thousands of SNPs. Also, recent studies have demonstrated that individuals with high genetic risk scores can attenuate their risk with lifestyle modifications and with statins, for which the benefit of treatment may be greater in those at highest genetic risk. Genetic risk scores when added to existing clinical models appear to improve risk prediction, particularly in the setting of incident cardiovascular disease and may provide actionable information to optimize prevention early in life. Future research will need to establish how to best use this genetic risk information either as a means to further individualize treatment decisions or to better identify high-risk populations.
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Affiliation(s)
- Christopher Labos
- Division of Cardiology, Preventive and Genomic Cardiology, McGill University Health Center, 1001 Boulevard Decarie, Montreal, QC, H4A 3J1, Canada
| | - George Thanassoulis
- Division of Cardiology, Preventive and Genomic Cardiology, McGill University Health Center, 1001 Boulevard Decarie, Montreal, QC, H4A 3J1, Canada.
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16
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Paquette M, Dufour R, Baass A. ABO blood group is a cardiovascular risk factor in patients with familial hypercholesterolemia. J Clin Lipidol 2018; 12:383-389.e1. [DOI: 10.1016/j.jacl.2017.12.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 10/31/2017] [Accepted: 12/04/2017] [Indexed: 11/29/2022]
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17
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Schiele F, Ecarnot F, Chopard R. Coronary artery disease: Risk stratification and patient selection for more aggressive secondary prevention. Eur J Prev Cardiol 2017; 24:88-100. [DOI: 10.1177/2047487317706586] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- François Schiele
- Department of Cardiology, University Hospital Besançon and EA3920, University of Burgundy Franche-Comté, Besançon, France
| | - Fiona Ecarnot
- Department of Cardiology, University Hospital Besançon and EA3920, University of Burgundy Franche-Comté, Besançon, France
| | - Romain Chopard
- Department of Cardiology, University Hospital Besançon and EA3920, University of Burgundy Franche-Comté, Besançon, France
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18
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Abstract
PURPOSE OF REVIEW Genome-wide association studies (GWAS) have identified ∼60 loci for coronary artery disease (CAD). Through genetic risk scores (GRSs), investigators are leveraging this genomic information to gain insights on both the fundamental mechanisms driving these associations as well as their utility in improving risk prediction. RECENT FINDINGS GRSs of CAD track with the earliest atherosclerosis lesions in the coronary including fatty streaks and uncomplicated raised lesions. In multiple cohort studies, they predict incident CAD events independent of all traditional and lifestyle risk factors. The incorporation of SNPs with suggestive but not genome-wide association in GWAS into GRSs often increases the strength of these associations. GRS may also predict recurrent events and identify patients most likely to respond to statins. The effect of the GRS on discrimination metrics remains modest but the minimal degree of improvement needed for clinical utility is unknown. SUMMARY Most novel loci for CAD identified through GWAS facilitate the formation of coronary atherosclerosis and stratify individuals based on their underlying burden of coronary atherosclerosis. GRSs may one day be routinely used in clinical practice to not only assess the risk of incident events but also to predict who will respond best to established prevention strategies.
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Affiliation(s)
- Themistocles L. Assimes
- Department of Medicine, Stanford University, Stanford,
California, USA
- Stanford Cardiovascular Institute, Stanford University,
Stanford, California, USA
| | - Elias L. Salfati
- Department of Medicine, Stanford University, Stanford,
California, USA
- Stanford Cardiovascular Institute, Stanford University,
Stanford, California, USA
| | - Liana Del Gobbo
- Department of Medicine, Stanford University, Stanford,
California, USA
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19
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Lee CJ, Lee JY, Oum CY, Youn JC, Kang SM, Choi D, Jang Y, Park S, Jee SH, Lee SH. The Effect of FLT1 Variant on Long-Term Cardiovascular Outcomes: Validation of a Locus Identified in a Previous Genome-Wide Association Study. PLoS One 2016; 11:e0164705. [PMID: 27736948 PMCID: PMC5063388 DOI: 10.1371/journal.pone.0164705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Accepted: 09/29/2016] [Indexed: 11/18/2022] Open
Abstract
Background Data on genetic variants that can predict follow-up cardiovascular events are highly limited, particularly for Asians. The aim of this study was to validate the effects of two variants in FLT1 and 9p21 on long-term cardiovascular outcomes in high-risk Korean patients. Methods We examined the prognostic values of the rs9508025 and rs1333049 variants that were found to be associated with coronary artery disease (CAD) risk in a previous Korean genome-wide association study. A total of 2693 patients (mean age: 55.2 years; male: 55.2%) with CAD or its risk factors at baseline were enrolled and followed for major adverse cardiac events (MACE). Results During the mean follow-up of 8.8 years, 15.4% of the patients experienced MACE. Kaplan-Meier curves showed that MACE-free survival was different according to the genotype of rs9508025 (log rank p = 0.02), whereas rs1333049 genotype did not correlate with the prognosis. Multivariate Cox proportional hazard analysis showed that C-allele of rs9508025 was significantly associated with a high rate of MACE, while rs1333049 was not. Further analyses demonstrated that the association of the rs9508025 variant with MACE was mainly due to its relation to coronary revascularization, which was also associated with the rs1333049 variant. In an additional analysis, rs9508025 was found to be an independent determinant of the outcome only in the subgroup with history of CAD. Conclusions rs9508025 in FLT1 was significantly associated with long-term cardiovascular events, particularly in patients with prior CAD. The association of rs1333049 in 9p21 was not significant.
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Affiliation(s)
- Chan Joo Lee
- Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
- Cardiovascular Research Institute and Cardiovascular Genome Center, Yonsei College of Medicine, Seoul, Korea
| | - Ji-Young Lee
- Cardiovascular Research Institute and Cardiovascular Genome Center, Yonsei College of Medicine, Seoul, Korea
| | - Chi-Yoon Oum
- Department of Biostatistics and Computing, the Graduate School, Yonsei University, Seoul, Korea
| | - Jong-Chan Youn
- Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
- Cardiovascular Research Institute and Cardiovascular Genome Center, Yonsei College of Medicine, Seoul, Korea
| | - Seok-Min Kang
- Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
- Cardiovascular Research Institute and Cardiovascular Genome Center, Yonsei College of Medicine, Seoul, Korea
| | - Donghoon Choi
- Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
- Cardiovascular Research Institute and Cardiovascular Genome Center, Yonsei College of Medicine, Seoul, Korea
| | - Yangsoo Jang
- Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
- Cardiovascular Research Institute and Cardiovascular Genome Center, Yonsei College of Medicine, Seoul, Korea
| | - Sungha Park
- Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
- Cardiovascular Research Institute and Cardiovascular Genome Center, Yonsei College of Medicine, Seoul, Korea
- * E-mail: (SHL); (SHJ); (SP)
| | - Sun Ha Jee
- Institute of Health Promotion, Graduate School of Public Health, Yonsei University, Seoul, Korea
- * E-mail: (SHL); (SHJ); (SP)
| | - Sang-Hak Lee
- Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
- Cardiovascular Research Institute and Cardiovascular Genome Center, Yonsei College of Medicine, Seoul, Korea
- * E-mail: (SHL); (SHJ); (SP)
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20
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Dungan JR, Qin X, Horne BD, Carlquist JF, Singh A, Hurdle M, Grass E, Haynes C, Gregory SG, Shah SH, Hauser ER, Kraus WE. Case-Only Survival Analysis Reveals Unique Effects of Genotype, Sex, and Coronary Disease Severity on Survivorship. PLoS One 2016; 11:e0154856. [PMID: 27187494 PMCID: PMC4871369 DOI: 10.1371/journal.pone.0154856] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Accepted: 04/20/2016] [Indexed: 01/05/2023] Open
Abstract
Survival bias may unduly impact genetic association with complex diseases; gene-specific survival effects may further complicate such investigations. Coronary artery disease (CAD) is a complex phenotype for which little is understood about gene-specific survival effects; yet, such information can offer insight into refining genetic associations, improving replications, and can provide candidate genes for both mortality risk and improved survivorship in CAD. Building on our previous work, the purpose of this current study was to: evaluate LSAMP SNP-specific hazards for all-cause mortality post-catheterization in a larger cohort of our CAD cases; and, perform additional replication in an independent dataset. We examined two LSAMP SNPs—rs1462845 and rs6788787—using CAD case-only Cox proportional hazards regression for additive genetic effects, censored on time-to-all-cause mortality or last follow-up among Caucasian subjects from the Catheterization Genetics Study (CATHGEN; n = 2,224) and the Intermountain Heart Collaborative Study (IMHC; n = 3,008). Only after controlling for age, sex, body mass index, histories of smoking, type 2 diabetes, hyperlipidemia and hypertension (HR = 1.11, 95%CI = 1.01–1.22, p = 0.032), rs1462845 conferred significantly increased hazards of all-cause mortality among CAD cases. Even after controlling for multiple covariates, but in only the primary cohort, rs6788787 conferred significantly improved survival (HR = 0.80, 95% CI = 0.69–0.92, p = 0.002). Post-hoc analyses further stratifying by sex and disease severity revealed replicated effects for rs1462845: even after adjusting for aforementioned covariates and coronary interventional procedures, males with severe burden of CAD had significantly amplified hazards of death with the minor variant of rs1462845 in both cohorts (HR = 1.29, 95% CI = 1.08–1.55, p = 0.00456; replication HR = 1.25, 95% CI = 1.05–1.49, p = 0.013). Kaplan-Meier curves revealed unique cohort-specific genotype effects on survival. Additional analyses demonstrated that the homozygous risk genotype (‘A/A’) fully explained the increased hazard in both cohorts. None of the post-hoc analyses in control subjects were significant for any model. This suggests that genetic effects of rs1462845 on survival are unique to CAD presence. This represents formal, replicated evidence of genetic contribution of rs1462845 to increased risk for all-cause mortality; the contribution is unique to CAD case status and specific to males with severe burden of CAD.
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Affiliation(s)
- Jennifer R. Dungan
- Duke University School of Nursing, Durham, NC, United States of America
- * E-mail:
| | - Xuejun Qin
- Duke University Department of Medicine, Durham, NC, United States of America
| | - Benjamin D. Horne
- Intermountain Heart Institute, Intermountain Medical Center, Salt Lake City, UT, United States of America
- Department of Internal Medicine, University of Utah, Salt Lake City, UT, United States of America
| | - John F. Carlquist
- Intermountain Heart Institute, Intermountain Medical Center, Salt Lake City, UT, United States of America
- Department of Internal Medicine, University of Utah, Salt Lake City, UT, United States of America
| | - Abanish Singh
- Behavioral Medicine Research Center, Duke University Medical Center, Durham, NC, United States of America
- Duke Molecular Physiology Institute, Duke University Medical Center, Durham, NC, United States of America
| | - Melissa Hurdle
- Duke University Department of Medicine, Durham, NC, United States of America
| | - Elizabeth Grass
- Duke University Department of Medicine, Durham, NC, United States of America
| | - Carol Haynes
- Duke University Department of Medicine, Durham, NC, United States of America
| | - Simon G. Gregory
- Duke University Department of Medicine, Durham, NC, United States of America
| | - Svati H. Shah
- Duke University Department of Medicine, Durham, NC, United States of America
- Duke Molecular Physiology Institute, Duke University Medical Center, Durham, NC, United States of America
| | - Elizabeth R. Hauser
- Duke Molecular Physiology Institute, Duke University Medical Center, Durham, NC, United States of America
- Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, NC, United States of America
| | - William E. Kraus
- Duke University Department of Medicine, Durham, NC, United States of America
- Duke Molecular Physiology Institute, Duke University Medical Center, Durham, NC, United States of America
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21
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The association between blood group and the risk of vascular disease in Quebec blood donors. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2016; 14:455-9. [PMID: 27177404 DOI: 10.2450/2016.0303-15] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Accepted: 01/18/2016] [Indexed: 12/31/2022]
Abstract
BACKGROUND The association between antigens A and B and arterial thrombosis, such as coronary heart disease, cerebrovascular disease or peripheral vascular disease, is still unclear. We evaluated the association between blood groups and thrombotic events in a cohort of blood donors from the province of Quebec, Canada. MATERIAL AND METHODS Among all whole blood donors aged ≥18 years in Quebec between June 1990 and March 2009, a study sample with known blood groups was linked with the provincial hospitalisation and death records to count vascular events. All hospital admissions and deaths with codes for primary and relevant secondary diagnoses of coronary, cerebrovascular or peripheral diseases, including coronary heart disease interventions, were included. Cox regression was used to evaluate the hazard ratio associated between blood groups and these events adjusted for other baseline characteristics. RESULTS Among the blood donors, 64,686 had a known blood group and were linked with the provincial health databases. The mean age of these donors was 38 years. The Cox multivariate adjusted hazard ratio for coronary, cerebrovascular or peripheral diseases was 1.19 (95% confidence interval: 1.01-1.40) for subjects with blood group AB compared to those with blood group O. There were no statistically significant associations with other blood groups. Only among women aged ≥40 years did those with blood group A have a higher hazard ratio for coronary heart disease (1.40 [1.01-1.92]) than those with blood group O, after adjusting for other characteristics. DISCUSSION When compared to blood group O, only blood group AB was associated with a higher risk of hospitalisation or death because of thrombotic events such as coronary, cerebrovascular or peripheral diseases. However, the associations differed according to age and sex because only females aged ≥40 years with blood group A had a higher risk of coronary heart disease.
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22
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Vaara S, Tikkanen E, Parkkonen O, Lokki ML, Ripatti S, Perola M, Nieminen MS, Sinisalo J. Genetic Risk Scores Predict Recurrence of Acute Coronary Syndrome. ACTA ACUST UNITED AC 2016; 9:172-8. [PMID: 26980882 DOI: 10.1161/circgenetics.115.001271] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Accepted: 03/14/2016] [Indexed: 11/16/2022]
Abstract
BACKGROUND Several clinical risk estimation tools have established their role in the prediction of recurrence of acute coronary syndrome (ACS), but the value of genetic risk scores (GRSs) remains unclear. We examined how well 2 different GRSs estimate recurrent ACS and whether clinical factors are associated with GRSs. METHODS AND RESULTS A cohort of 2090 consecutive patients with ACS who underwent coronary angiography between July 2006 and March 2008 in a single tertiary center was genotyped and prospectively followed up for a median of 5.5 years. We formed 2 partially overlapping GRSs: GRS47 of 47 single-nucleotide polymorphisms with previously reported significant association with coronary artery disease and GRS153 of 153 single-nucleotide polymorphisms with significant or suggestive association with coronary artery disease. GRS47 showed association with recurrent ACS independent of clinical factors (P=0.037; hazard ratio, 1.17; 95% confidence interval, 1.01-1.36). GRS153 had no association with either recurrent ACS or composite of recurrent ACS or death. Also, GRS47 was associated inversely with smoking and ST-segment-elevation myocardial infarction (P=0.004; odds ratio, 0.22; 95% confidence interval, 0.08-0.62 and P=0.041; odds ratio, 0.36; 95% confidence interval, 0.13-0.96, respectively). CONCLUSIONS GRSs combined of 47 known coronary artery disease risk single-nucleotide polymorphisms were associated with recurrent ACS after multivariable adjustments in a heterogenic ACS population for the first time. Smoking and ST-segment-elevation myocardial infarction had an inverse association with the GRSs. The significance of smoking in relation to genetic coronary artery disease predisposition may merit further evaluation in patients with ACS.
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Affiliation(s)
- Satu Vaara
- From the Division of Cardiology, Heart and Lung Center, Helsinki University Central Hospital, Helsinki, Finland (S.V., O.P., M.S.N., J.S.); Public Health Genomics Unit, Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland (E.T., S.P., M.P.); and Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland (E.T., S.P., M.P.) and Transplantation Laboratory, Haartman Institute, University of Helsinki, Helsinki, Finland (M.-L.L.)
| | - Emmi Tikkanen
- From the Division of Cardiology, Heart and Lung Center, Helsinki University Central Hospital, Helsinki, Finland (S.V., O.P., M.S.N., J.S.); Public Health Genomics Unit, Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland (E.T., S.P., M.P.); and Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland (E.T., S.P., M.P.) and Transplantation Laboratory, Haartman Institute, University of Helsinki, Helsinki, Finland (M.-L.L.)
| | - Olavi Parkkonen
- From the Division of Cardiology, Heart and Lung Center, Helsinki University Central Hospital, Helsinki, Finland (S.V., O.P., M.S.N., J.S.); Public Health Genomics Unit, Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland (E.T., S.P., M.P.); and Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland (E.T., S.P., M.P.) and Transplantation Laboratory, Haartman Institute, University of Helsinki, Helsinki, Finland (M.-L.L.)
| | - Marja-Liisa Lokki
- From the Division of Cardiology, Heart and Lung Center, Helsinki University Central Hospital, Helsinki, Finland (S.V., O.P., M.S.N., J.S.); Public Health Genomics Unit, Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland (E.T., S.P., M.P.); and Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland (E.T., S.P., M.P.) and Transplantation Laboratory, Haartman Institute, University of Helsinki, Helsinki, Finland (M.-L.L.)
| | - Samuli Ripatti
- From the Division of Cardiology, Heart and Lung Center, Helsinki University Central Hospital, Helsinki, Finland (S.V., O.P., M.S.N., J.S.); Public Health Genomics Unit, Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland (E.T., S.P., M.P.); and Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland (E.T., S.P., M.P.) and Transplantation Laboratory, Haartman Institute, University of Helsinki, Helsinki, Finland (M.-L.L.)
| | - Markus Perola
- From the Division of Cardiology, Heart and Lung Center, Helsinki University Central Hospital, Helsinki, Finland (S.V., O.P., M.S.N., J.S.); Public Health Genomics Unit, Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland (E.T., S.P., M.P.); and Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland (E.T., S.P., M.P.) and Transplantation Laboratory, Haartman Institute, University of Helsinki, Helsinki, Finland (M.-L.L.)
| | - Markku S Nieminen
- From the Division of Cardiology, Heart and Lung Center, Helsinki University Central Hospital, Helsinki, Finland (S.V., O.P., M.S.N., J.S.); Public Health Genomics Unit, Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland (E.T., S.P., M.P.); and Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland (E.T., S.P., M.P.) and Transplantation Laboratory, Haartman Institute, University of Helsinki, Helsinki, Finland (M.-L.L.)
| | - Juha Sinisalo
- From the Division of Cardiology, Heart and Lung Center, Helsinki University Central Hospital, Helsinki, Finland (S.V., O.P., M.S.N., J.S.); Public Health Genomics Unit, Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland (E.T., S.P., M.P.); and Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland (E.T., S.P., M.P.) and Transplantation Laboratory, Haartman Institute, University of Helsinki, Helsinki, Finland (M.-L.L.).
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Investigation of associations between ten polymorphisms and the risk of coronary artery disease in Southern Han Chinese. J Hum Genet 2016; 61:389-93. [PMID: 26740236 DOI: 10.1038/jhg.2015.158] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Revised: 12/01/2015] [Accepted: 12/02/2015] [Indexed: 11/08/2022]
Abstract
A large-scale meta-analysis of 14 genome-wide association studies has identified and replicated a series of susceptibility polymorphisms for coronary artery disease (CAD) in European ancestry populations, but evidences for the associations of these loci with CAD in other ethnicities remain lacking. Herein we investigated the associations between ten (rs579459, rs12413409, rs964184, rs4773144, rs2895811, rs3825807, rs216172, rs12936587, rs46522 and rs3798220) of these loci and CAD in Southern Han Chinese (CHS). Genotyping was performed in 1716 CAD patients and 1572 controls using mass spectrography. Both allelic and genotypic associations of rs964184, rs2895811 and rs3798220 with CAD were significant, regardless of adjustment for covariates of gender, age, hypertension, type 2 diabetes, blood lipid profiles and smoking. Significant association of rs12413409 was initially not observed, but after the adjustment for the covariates, both allelic and genotypic associations were identified as significant. Neither allelic nor genotypic association of the other six polymorphisms with CAD was significant regardless of the adjustment. Our results indicated that four loci of the total 10 were associated with CAD in CHS. Therefore, some of the CAD-related loci in European ancestry populations are indeed susceptibility loci for the risk of CAD in Han Chinese.
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Labos C, Martinez SC, Leo Wang RH, Lenzini PA, Pilote L, Bogaty P, Brophy JM, Engert JC, Cresci S, Thanassoulis G. Utility of a genetic risk score to predict recurrent cardiovascular events 1 year after an acute coronary syndrome: A pooled analysis of the RISCA, PRAXY, and TRIUMPH cohorts. Atherosclerosis 2015; 242:261-7. [PMID: 26232166 PMCID: PMC4772857 DOI: 10.1016/j.atherosclerosis.2015.07.029] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2015] [Revised: 07/08/2015] [Accepted: 07/14/2015] [Indexed: 12/30/2022]
Abstract
BACKGROUND Limited evidence exists regarding the utility of genetic risk scores (GRS) in predicting recurrent cardiovascular events after acute coronary syndrome (ACS). We sought to determine whether a GRS would predict early recurrent cardiovascular events within 1 year of ACS. METHODS & RESULTS Participants admitted with acute coronary syndromes from the RISCA, PRAXY, and TRIUMPH cohorts, were genotyped for 30 single nucleotide polymorphisms (SNPs) associated with coronary artery disease (CAD) or myocardial infarction (MI) in prior genome wide association studies. A 30 SNP CAD/MI GRS was constructed. The primary endpoint was defined as all-cause mortality, recurrent ACS or cardiac re-hospitalization within 1 year of ACS admission. Results across all cohorts for the 30 SNP CAD/MI GRS were pooled using a random-effects model. There were 1040 patients from the RISCA cohort, 691 patients from the PRAXY cohort, and 1772 patients from the TRIUMPH cohort included in the analysis and 389 occurrences of the primary endpoint of recurrent events at 1-year post-ACS. In unadjusted and fully adjusted analyses, a 30 SNP GRS was not significantly associated with recurrent events (HR per allele 0.97 (95%CI 0.91-1.03) for RISCA, HR 0.99 (95%CI 0.93-1.05) for PRAXY, 0.98 (95%CI 0.94-1.02) for TRIUMPH, and 0.98 (95%CI 0.95-1.01) for the pooled analysis). Addition of this GRS to the GRACE risk model did not significantly improve risk prediction. CONCLUSION The 30 MI SNP GRS was not associated with recurrent events 1-year post ACS in pooled analyses across cohorts and did not improve risk discrimination or reclassification indices. Our results suggest that the genetic etiology of early events post-ACS may differ from later events.
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Affiliation(s)
- Christopher Labos
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada
| | - Sara C Martinez
- Department of Medicine, Washington University, St. Louis, MO, USA
| | - Rui Hao Leo Wang
- Department of Biochemistry, McGill University, Montreal, QC, Canada
| | - Petra A Lenzini
- Department of Genetics, Washington University, St. Louis, MO, USA
| | - Louise Pilote
- Department of Medicine, McGill University, Montreal, QC, Canada
| | - Peter Bogaty
- Institut Universitaire de Cardiologie et de Pneumologie, Laval University, Quebec City, QC, Canada
| | - James M Brophy
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada; Department of Medicine, McGill University, Montreal, QC, Canada
| | - James C Engert
- Department of Medicine, McGill University, Montreal, QC, Canada; Department of Human Genetics, McGill University, Montreal, QC, Canada
| | - Sharon Cresci
- Department of Medicine, Washington University, St. Louis, MO, USA; Department of Genetics, Washington University, St. Louis, MO, USA
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Lüscher TF. Towards personalized prevention in special patient populations. Eur Heart J 2015; 36:1699-701. [PMID: 26173933 DOI: 10.1093/eurheartj/ehv232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Thomas F Lüscher
- Editor-in-Chief, Zurich Heart House, Careum Campus, Moussonstrasse 4, 8091 Zurich, Switzerland
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26
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Affiliation(s)
- Heribert Schunkert
- Deutsches Herzzentrum München and Technische Universität München, DZHK Munich Heart Alliance, D-80636 Munich, Germany.
| | - Nilesh J Samani
- Department of Cardiovascular Sciences, University of Leicester, and NIHR Leicester Cardiovascular Biomedical Research Unit, BHF Cardiovascular Research Centre, Leicester, UK
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27
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Mega JL, Stitziel NO, Smith JG, Chasman DI, Caulfield M, Devlin JJ, Nordio F, Hyde C, Cannon CP, Sacks F, Poulter N, Sever P, Ridker PM, Braunwald E, Melander O, Kathiresan S, Sabatine MS. Genetic risk, coronary heart disease events, and the clinical benefit of statin therapy: an analysis of primary and secondary prevention trials. Lancet 2015; 385:2264-2271. [PMID: 25748612 PMCID: PMC4608367 DOI: 10.1016/s0140-6736(14)61730-x] [Citation(s) in RCA: 470] [Impact Index Per Article: 52.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Genetic variants have been associated with the risk of coronary heart disease. In this study, we tested whether or not a composite of these variants could ascertain the risk of both incident and recurrent coronary heart disease events and identify those individuals who derive greater clinical benefit from statin therapy. METHODS A community-based cohort study (the Malmo Diet and Cancer Study) and four randomised controlled trials of both primary prevention (JUPITER and ASCOT) and secondary prevention (CARE and PROVE IT-TIMI 22) with statin therapy, comprising a total of 48,421 individuals and 3477 events, were included in these analyses. We studied the association of a genetic risk score based on 27 genetic variants with incident or recurrent coronary heart disease, adjusting for traditional clinical risk factors. We then investigated the relative and absolute risk reductions in coronary heart disease events with statin therapy stratified by genetic risk. We combined data from the different studies using a meta-analysis. FINDINGS When individuals were divided into low (quintile 1), intermediate (quintiles 2-4), and high (quintile 5) genetic risk categories, a significant gradient in risk for incident or recurrent coronary heart disease was shown. Compared with the low genetic risk category, the multivariable-adjusted hazard ratio for coronary heart disease for the intermediate genetic risk category was 1·34 (95% CI 1·22-1·47, p<0·0001) and that for the high genetic risk category was 1·72 (1·55-1·92, p<0·0001). In terms of the benefit of statin therapy in the four randomised trials, we noted a significant gradient (p=0·0277) of increasing relative risk reductions across the low (13%), intermediate (29%), and high (48%) genetic risk categories. Similarly, we noted greater absolute risk reductions in those individuals in higher genetic risk categories (p=0·0101), resulting in a roughly threefold decrease in the number needed to treat to prevent one coronary heart disease event in the primary prevention trials. Specifically, in the primary prevention trials, the number needed to treat to prevent one such event in 10 years was 66 in people at low genetic risk, 42 in those at intermediate genetic risk, and 25 in those at high genetic risk in JUPITER, and 57, 47, and 20, respectively, in ASCOT. INTERPRETATION A genetic risk score identified individuals at increased risk for both incident and recurrent coronary heart disease events. People with the highest burden of genetic risk derived the largest relative and absolute clinical benefit from statin therapy. FUNDING National Institutes of Health.
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Affiliation(s)
- J L Mega
- TIMI Study Group, Cardiovascular Division, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - N O Stitziel
- Cardiovascular Division, Department of Medicine and Division of Statistical Genomics, Washington University School of Medicine, Saint Louis, MO
| | - J G Smith
- Department of Cardiology, Clinical Sciences, Lund University and Skåne University Hospital, Lund, Sweden
- Program in Medical and Population Genetics, Broad Institute of Harvard and MIT; Center for Human Genetic Research and Cardiovascular Research Center, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - D I Chasman
- Center for Cardiovascular Disease Prevention, Divisions of Preventive Medicine and Genetics, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - M Caulfield
- William Harvey Research Institute, Queen Mary University of London and Barts NIHR CV Biomedical Research Institute, London, United Kingdom
| | | | - F Nordio
- TIMI Study Group, Cardiovascular Division, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - C Hyde
- Pfizer Research Laboratory, Groton, CT
| | - C P Cannon
- TIMI Study Group, Cardiovascular Division, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - F Sacks
- Department of Nutrition, Harvard School of Public Health and Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA
| | - N Poulter
- International Centre for Circulatory Health, National Heart & Lung Institute, Imperial College London, United Kingdom
| | - P Sever
- International Centre for Circulatory Health, National Heart & Lung Institute, Imperial College London, United Kingdom
| | - P M Ridker
- Center for Cardiovascular Disease Prevention, Divisions of Preventive Medicine and Cardiology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - E Braunwald
- TIMI Study Group, Cardiovascular Division, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - O Melander
- Department of Clinical Sciences, Faculty of Medicine, Lund University and Department of Internal Medicine, Skåne University Hospital, Malmö, Sweden
| | - S Kathiresan
- Program in Medical and Population Genetics, Broad Institute of Harvard and MIT; Center for Human Genetic Research and Cardiovascular Research Center, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - M S Sabatine
- TIMI Study Group, Cardiovascular Division, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
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28
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Lin Y, Sibanda VL, Zhang HM, Hu H, Liu H, Guo AY. MiRNA and TF co-regulatory network analysis for the pathology and recurrence of myocardial infarction. Sci Rep 2015; 5:9653. [PMID: 25867756 PMCID: PMC4394890 DOI: 10.1038/srep09653] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Accepted: 03/16/2015] [Indexed: 12/15/2022] Open
Abstract
Myocardial infarction (MI) is a leading cause of death in the world and many genes are involved in it. Transcription factor (TFs) and microRNAs (miRNAs) are key regulators of gene expression. We hypothesized that miRNAs and TFs might play combinatory regulatory roles in MI. After collecting MI candidate genes and miRNAs from various resources, we constructed a comprehensive MI-specific miRNA-TF co-regulatory network by integrating predicted and experimentally validated TF and miRNA targets. We found some hub nodes (e.g. miR-16 and miR-26) in this network are important regulators, and the network can be severed as a bridge to interpret the associations of previous results, which is shown by the case of miR-29 in this study. We also constructed a regulatory network for MI recurrence and found several important genes (e.g. DAB2, BMP6, miR-320 and miR-103), the abnormal expressions of which may be potential regulatory mechanisms and markers of MI recurrence. At last we proposed a cellular model to discuss major TF and miRNA regulators with signaling pathways in MI. This study provides more details on gene expression regulation and regulators involved in MI progression and recurrence. It also linked up and interpreted many previous results.
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Affiliation(s)
- Ying Lin
- Hubei Bioinformatics &Molecular Imaging Key Laboratory, Department of Biomedical Engineering, Key Laboratory of Molecular Biophysics of the Ministry of Education, College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan, 430074, China
| | - Vusumuzi Leroy Sibanda
- Hubei Bioinformatics &Molecular Imaging Key Laboratory, Department of Biomedical Engineering, Key Laboratory of Molecular Biophysics of the Ministry of Education, College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan, 430074, China
| | - Hong-Mei Zhang
- Hubei Bioinformatics &Molecular Imaging Key Laboratory, Department of Biomedical Engineering, Key Laboratory of Molecular Biophysics of the Ministry of Education, College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan, 430074, China
| | - Hui Hu
- Hubei Bioinformatics &Molecular Imaging Key Laboratory, Department of Biomedical Engineering, Key Laboratory of Molecular Biophysics of the Ministry of Education, College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan, 430074, China
| | - Hui Liu
- Hubei Bioinformatics &Molecular Imaging Key Laboratory, Department of Biomedical Engineering, Key Laboratory of Molecular Biophysics of the Ministry of Education, College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan, 430074, China
| | - An-Yuan Guo
- Hubei Bioinformatics &Molecular Imaging Key Laboratory, Department of Biomedical Engineering, Key Laboratory of Molecular Biophysics of the Ministry of Education, College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan, 430074, China
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29
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Gong P, Luo SH, Li XL, Guo YL, Zhu CG, Xu RX, Li S, Dong Q, Liu G, Chen J, Zeng RX, Li JJ. Relation of ABO blood groups to the severity of coronary atherosclerosis: An Gensini score assessment. Atherosclerosis 2014; 237:748-53. [PMID: 25463115 DOI: 10.1016/j.atherosclerosis.2014.10.107] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2014] [Revised: 10/13/2014] [Accepted: 10/29/2014] [Indexed: 11/27/2022]
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30
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Montecucco F, Carbone F, Dini FL, Fiuza M, Pinto FJ, Martelli A, Palombo D, Sambuceti G, Mach F, De Caterina R. Implementation strategies of Systems Medicine in clinical research and home care for cardiovascular disease patients. Eur J Intern Med 2014; 25:785-94. [PMID: 25283057 DOI: 10.1016/j.ejim.2014.09.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Revised: 09/16/2014] [Accepted: 09/22/2014] [Indexed: 12/24/2022]
Abstract
Insights from the "-omics" science have recently emphasized the need to implement an overall strategy in medical research. Here, the development of Systems Medicine has been indicated as a potential tool for clinical translation of basic research discoveries. Systems Medicine also gives the opportunity of improving different steps in medical practice, from diagnosis to healthcare management, including clinical research. The development of Systems Medicine is still hampered however by several challenges, the main one being the development of computational tools adequate to record, analyze and share a large amount of disparate data. In addition, available informatics tools appear not yet fully suitable for the challenge because they are not standardized, not universally available, or with ethical/legal concerns. Cardiovascular diseases (CVD) are a very promising area for translating Systems Medicine into clinical practice. By developing clinically applied technologies, the collection and analysis of data may improve CV risk stratification and prediction. Standardized models for data recording and analysis can also greatly broaden data exchange, thus promoting a uniform management of CVD patients also useful for clinical research. This advance however requires a great organizational effort by both physicians and health institutions, as well as the overcoming of ethical problems. This narrative review aims at providing an update on the state-of-art knowledge in the area of Systems Medicine as applied to CVD, focusing on current critical issues, providing a road map for its practical implementation.
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Affiliation(s)
- Fabrizio Montecucco
- Division of Laboratory Medicine, Department of Genetics and Laboratory Medicine, Geneva University Hospitals, 4 rue Gabrielle-Perret-Gentil, 1205 Geneva, Switzerland; Division of Cardiology, Foundation for Medical Researches, Department of Medical Specialties, University of Geneva, 64 avenue de la Roseraie, 1211 Geneva, Switzerland; Department of Internal Medicine, University of Genoa School of Medicine, IRCCS Azienda Ospedaliera Universitaria San Martino-IST Istituto Nazionale per la Ricerca sul Cancro, 6 viale Benedetto XV, 16132 Genoa, Italy.
| | - Federico Carbone
- Division of Cardiology, Foundation for Medical Researches, Department of Medical Specialties, University of Geneva, 64 avenue de la Roseraie, 1211 Geneva, Switzerland; Department of Internal Medicine, University of Genoa School of Medicine, IRCCS Azienda Ospedaliera Universitaria San Martino-IST Istituto Nazionale per la Ricerca sul Cancro, 6 viale Benedetto XV, 16132 Genoa, Italy
| | - Frank Lloyd Dini
- Cardiac, Thoracic and Vascular Department, University of Pisa, Azienda Universitaria-Ospedaliera Pisana, Via Paradisa, 2, 56124 Pisa, Italy
| | - Manuela Fiuza
- Serviço de Cardiologia 1, Hospital de Santa Maria (CHLN), Lisboa, Portugal
| | - Fausto J Pinto
- Serviço de Cardiologia 1, Hospital de Santa Maria (CHLN), Lisboa, Portugal
| | - Antonietta Martelli
- Department of Internal Medicine, University of Genoa School of Medicine, IRCCS Azienda Ospedaliera Universitaria San Martino-IST Istituto Nazionale per la Ricerca sul Cancro, 6 viale Benedetto XV, 16132 Genoa, Italy
| | - Domenico Palombo
- Vascular and Endovascular Surgery Unit, Department of Surgery, San Martino Hospital, 10 Largo Rosanna Benzi, 16132 Genoa, Italy
| | - Gianmario Sambuceti
- Department of Nuclear Medicine Unit, IRCCS San Martino-IST, University of Genoa, L.go R. Benzi 10, 16132 Genoa, Italy
| | - François Mach
- Division of Cardiology, Foundation for Medical Researches, Department of Medical Specialties, University of Geneva, 64 avenue de la Roseraie, 1211 Geneva, Switzerland
| | - Raffaele De Caterina
- Institute of Cardiology and Center of Excellence on Aging, G. d'Annunzio University - Chieti-Pescara, Italy; G. Monasterio Foundation, Pisa, Italy
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31
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Franchini M, Mannucci PM. ABO blood group and thrombotic vascular disease. Thromb Haemost 2014; 112:1103-9. [PMID: 25187297 DOI: 10.1160/th14-05-0457] [Citation(s) in RCA: 76] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2014] [Accepted: 07/22/2014] [Indexed: 01/15/2023]
Abstract
ABO blood group antigens are complex carbohydrate molecules expressed on red blood cells and a variety of tissues. The ABO blood type is implicated in the development of a number of human diseases and there is increasing evidence regarding its involvement in the pathogenesis of cardiovascular disorders, mainly through its effect on von Willebrand factor levels. In this review, after a brief analysis of the potential molecular mechanisms by which the blood group influences haemostasis, we focus on the clinical implications of such interaction. Overall, the literature data document the close relationship between venous thromboembolism (VTE) and non-O blood type, which is associated with an approximately two-fold increased risk of venous thrombosis. A supra-additive effect on VTE risk is observed when an inherited thrombophilic condition is associated with non-O blood group. A weaker association exists between non-O blood type and arterial thrombosis, which needs to be further investigated.
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Affiliation(s)
- M Franchini
- Massimo Franchini, MD, Director, Dipartimento di Medicina Trasfusionale ed Ematologia, Azienda Ospedaliera Carlo Poma, Mantova, Italy, Tel.: +39 0376 201234, Fax: +39 0376 220144, E-mail:
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Patel RS, Asselbergs FW, Quyyumi AA, Palmer TM, Finan CI, Tragante V, Deanfield J, Hemingway H, Hingorani AD, Holmes MV. Genetic variants at chromosome 9p21 and risk of first versus subsequent coronary heart disease events: a systematic review and meta-analysis. J Am Coll Cardiol 2014; 63:2234-45. [PMID: 24607648 PMCID: PMC4035794 DOI: 10.1016/j.jacc.2014.01.065] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2013] [Revised: 01/07/2014] [Accepted: 01/22/2014] [Indexed: 11/30/2022]
Abstract
Objectives The purpose of this analysis was to compare the association between variants at the chromosome 9p21 locus (Ch9p21) and risk of first versus subsequent coronary heart disease (CHD) events through systematic review and meta-analysis. Background Ch9p21 is a recognized risk factor for a first CHD event. However, its association with risk of subsequent events in patients with established CHD is less clear. Methods We searched PubMed and EMBASE for prospective studies reporting association of Ch9p21 with incident CHD events and extracted information on cohort type (individuals without prior CHD or individuals with established CHD) and effect estimates for risk of events. Results We identified 31 cohorts reporting on 193,372 individuals. Among the 16 cohorts of individuals without prior CHD (n = 168,209), there were 15,664 first CHD events. Ch9p21 was associated with a pooled hazard ratio (HR) of a first event of 1.19 (95% confidence interval: 1.17 to 1.22) per risk allele. In individuals with established CHD (n = 25,163), there were 4,436 subsequent events providing >99% and 91% power to detect a per-allele HR of 1.19 or 1.10, respectively. The pooled HR for subsequent events was 1.01 (95% confidence interval: 0.97 to 1.06) per risk allele. There was strong evidence of heterogeneity between the effect estimates for first and subsequent events (p value for heterogeneity = 5.6 × 10−11). We found no evidence for biases to account for these findings. Conclusions Ch9p21 shows differential association with risk of first versus subsequent CHD events. This has implications for genetic risk prediction in patients with established CHD and for mechanistic understanding of how Ch9p21 influences risk of CHD.
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Affiliation(s)
- Riyaz S Patel
- Department of Epidemiology and Public Health, University College London, London, United Kingdom; Department of Cardiology, The Heart Hospital, University College London NHS Trust, London, United Kingdom; Genetic Epidemiology Group, Department of Epidemiology and Public Health, Institute of Cardiovascular Science, University College London, London, United Kingdom.
| | - Folkert W Asselbergs
- Genetic Epidemiology Group, Department of Epidemiology and Public Health, Institute of Cardiovascular Science, University College London, London, United Kingdom; Department of Cardiology, Division of Heart & Lungs, University Medical Center, Utrecht, the Netherlands; Durrer Center for Cardiogenetic Research, ICIN-Netherlands Heart Institute, Utrecht, the Netherlands
| | - Arshed A Quyyumi
- Department of Medicine, Emory Clinical Cardiovascular Research Institute, Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia
| | - Tom M Palmer
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Chris I Finan
- Genetic Epidemiology Group, Department of Epidemiology and Public Health, Institute of Cardiovascular Science, University College London, London, United Kingdom
| | - Vinicius Tragante
- Department of Cardiology, Division of Heart & Lungs, University Medical Center, Utrecht, the Netherlands
| | - John Deanfield
- National Institute for Cardiovascular Outcome Research, University College London, London, United Kingdom
| | - Harry Hemingway
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Aroon D Hingorani
- Genetic Epidemiology Group, Department of Epidemiology and Public Health, Institute of Cardiovascular Science, University College London, London, United Kingdom
| | - Michael V Holmes
- Genetic Epidemiology Group, Department of Epidemiology and Public Health, Institute of Cardiovascular Science, University College London, London, United Kingdom; Department of Surgery, Division of Transplantation, and Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
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