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载脂蛋白相关 LPA 和 9p21 基因座对主动脉瓣狭窄风险的影响。

Effects of the coronary artery disease associated LPA and 9p21 loci on risk of aortic valve stenosis.

机构信息

Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Technical University Munich, Munich, Germany.

Department of Cardiovascular Sciences, Cardiovascular Research Centre, NIHR Leicester Biomedical Research Centre University of Leicester, Leicester, United Kingdom.

出版信息

Int J Cardiol. 2019 Feb 1;276:212-217. doi: 10.1016/j.ijcard.2018.11.094. Epub 2018 Nov 17.


DOI:10.1016/j.ijcard.2018.11.094
PMID:30482443
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6878659/
Abstract

BACKGROUND: Aortic valve stenosis (AVS) and coronary artery disease (CAD) have a significant genetic contribution and commonly co-exist. To compare and contrast genetic determinants of the two diseases, we investigated associations of the LPA and 9p21 loci, i.e. the two strongest CAD risk loci, with risk of AVS. METHODS: We genotyped the CAD-associated variants at the LPA (rs10455872) and 9p21 loci (rs1333049) in the GeneCAST (Genetics of Calcific Aortic STenosis) Consortium and conducted a meta-analysis for their association with AVS. Cases and controls were stratified by CAD status. External validation of findings was undertaken in five cohorts including 7880 cases and 851,152 controls. RESULTS: In the meta-analysis including 4651 cases and 8231 controls the CAD-associated allele at the LPA locus was associated with increased risk of AVS (OR 1.37; 95%CI 1.24-1.52, p = 6.9 × 10) with a larger effect size in those without CAD (OR 1.53; 95%CI 1.31-1.79) compared to those with CAD (OR 1.27; 95%CI 1.12-1.45). The CAD-associated allele at 9p21 was associated with a trend towards lower risk of AVS (OR 0.93; 95%CI 0.88-0.99, p = 0.014). External validation confirmed the association of the LPA risk allele with risk of AVS (OR 1.37; 95%CI 1.27-1.47), again with a higher effect size in those without CAD. The small protective effect of the 9p21 CAD risk allele could not be replicated (OR 0.98; 95%CI 0.95-1.02). CONCLUSIONS: Our study confirms the association of the LPA locus with risk of AVS, with a higher effect in those without concomitant CAD. Overall, 9p21 was not associated with AVS.

摘要

背景:主动脉瓣狭窄(AVS)和冠状动脉疾病(CAD)具有显著的遗传贡献,并且通常同时存在。为了比较和对比这两种疾病的遗传决定因素,我们研究了 LPA 和 9p21 位点(即两个最强的 CAD 风险位点)与 AVS 风险的关联。

方法:我们在 GeneCAST(Genetics of Calcific Aortic STenosis)联盟中对 LPA(rs10455872)和 9p21 位点(rs1333049)的 CAD 相关变体进行了基因分型,并对其与 AVS 的关联进行了荟萃分析。病例和对照按 CAD 状态分层。在包括 7880 例病例和 851152 例对照的五个队列中进行了发现的外部验证。

结果:在包括 4651 例病例和 8231 例对照的荟萃分析中,LPA 位点的 CAD 相关等位基因与 AVS 风险增加相关(OR 1.37;95%CI 1.24-1.52,p=6.9×10),在无 CAD 的患者中效应更大(OR 1.53;95%CI 1.31-1.79)与 CAD 患者相比(OR 1.27;95%CI 1.12-1.45)。9p21 的 CAD 相关等位基因与 AVS 风险降低呈趋势相关(OR 0.93;95%CI 0.88-0.99,p=0.014)。外部验证证实了 LPA 风险等位基因与 AVS 风险的关联(OR 1.37;95%CI 1.27-1.47),在无 CAD 的患者中,其效应更大。9p21 CAD 风险等位基因的微小保护作用无法复制(OR 0.98;95%CI 0.95-1.02)。

结论:我们的研究证实了 LPA 位点与 AVS 风险的关联,在无合并 CAD 的患者中,其效应更高。总体而言,9p21 与 AVS 无关。

相似文献

[1]
Effects of the coronary artery disease associated LPA and 9p21 loci on risk of aortic valve stenosis.

Int J Cardiol. 2018-11-17

[2]
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JAMA Cardiol. 2019-7-1

[3]
Association of LPA Variants With Aortic Stenosis: A Large-Scale Study Using Diagnostic and Procedural Codes From Electronic Health Records.

JAMA Cardiol. 2018-1-1

[4]
Common SNP-based haplotype analysis of the 9p21.3 gene locus as predictor coronary artery disease in Tanzanian population.

Cell Mol Biol (Noisy-le-grand). 2019-7-31

[5]
Repeated replication and a prospective meta-analysis of the association between chromosome 9p21.3 and coronary artery disease.

Circulation. 2008-4-1

[6]
The association of polymorphic variants, rs2267788, rs1333049 and rs2383207 with coronary artery disease, its severity and presentation in North Indian population.

Gene. 2018-3-30

[7]
Genetic analysis of the 9p21.3 CAD risk locus in Asian Indians.

Thromb Haemost. 2014-5-5

[8]
The 9p21 locus is associated with coronary artery disease and cardiovascular events in the presence (but not in the absence) of coronary calcification.

PLoS One. 2014-4-14

[9]
Genetic associations with valvular calcification and aortic stenosis.

N Engl J Med. 2013-2-7

[10]
Association between the chromosome 9p21 locus and angiographic coronary artery disease burden: a collaborative meta-analysis.

J Am Coll Cardiol. 2013-1-23

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[2]
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[3]
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[4]
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[5]
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[6]
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[7]
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[8]
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[9]
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本文引用的文献

[1]
Genome-wide analysis yields new loci associating with aortic valve stenosis.

Nat Commun. 2018-3-7

[2]
Association of LPA Variants With Aortic Stenosis: A Large-Scale Study Using Diagnostic and Procedural Codes From Electronic Health Records.

JAMA Cardiol. 2018-1-1

[3]
2017 ESC/EACTS Guidelines for the management of valvular heart disease.

Eur Heart J. 2017-9-21

[4]
Association Between Cardiovascular Risk Factors and Aortic Stenosis: The CANHEART Aortic Stenosis Study.

J Am Coll Cardiol. 2017-3-28

[5]
A Replicated, Genome-Wide Significant Association of Aortic Stenosis With a Genetic Variant for Lipoprotein(a): Meta-Analysis of Published and Novel Data.

Circulation. 2017-3-21

[6]
Estimating the Population Impact of Lp(a) Lowering on the Incidence of Myocardial Infarction and Aortic Stenosis-Brief Report.

Arterioscler Thromb Vasc Biol. 2016-12

[7]
Antisense oligonucleotides targeting apolipoprotein(a) in people with raised lipoprotein(a): two randomised, double-blind, placebo-controlled, dose-ranging trials.

Lancet. 2016-9-21

[8]
PCSK9 R46L Loss-of-Function Mutation Reduces Lipoprotein(a), LDL Cholesterol, and Risk of Aortic Valve Stenosis.

J Clin Endocrinol Metab. 2016-9

[9]
Variants with large effects on blood lipids and the role of cholesterol and triglycerides in coronary disease.

Nat Genet. 2016-6

[10]
PCSK9 Inhibitors and Cardiovascular Events.

N Engl J Med. 2015-8-20

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