Association of genetic variants previously implicated in coronary artery disease with age at onset of coronary artery disease requiring revascularizations

Research output: Contribution to journalJournal articleResearchpeer-review

Charlotte Andersson, Maria Lukács Krogager, Regitze Kuhr Skals, Emil Vincent Rosenbaum Appel, Christian Theil Have, Niels Grarup, Oluf Pedersen, Jørgen L Jeppesen, Ole Dyg Pedersen, Helena Dominguez, Ulrik Dixen, Thomas Engstrøm, Niels Tønder, Dan M Roden, Steen Stender, Gunnar H Gislason, Henrik Enghusen-Poulsen, Torben Hansen, Lars Køber, Christian Torp-Pedersen & 1 others Peter E Weeke

Background: The relation between burden of risk factors, familial coronary artery disease (CAD), and known genetic variants underlying CAD and low-density lipoprotein cholesterol (LDL-C) levels is not well-explored in clinical samples. We aimed to investigate the association of these measures with age at onset of CAD requiring revascularizations in a clinical sample of patients undergoing first-time coronary angiography.

Methods: 1599 individuals (mean age 64 years [min-max 29–96 years], 28% women) were genotyped (from blood drawn as part of usual clinical care) in the Copenhagen area (2010–2014). The burden of common genetic variants was measured as aggregated genetic risk scores (GRS) of single nucleotide polymorphisms (SNPs) discovered in genome-wide association studies.

Results: Self-reported familial CAD (prevalent in 41% of the sample) was associated with -3.2 years (95% confidence interval -4.5, -2.2, p<0.0001) earlier need of revascularization in sex-adjusted models. Patients with and without familial CAD had similar mean values of CAD-GRS (unweighted scores 68.4 vs. 68.0, p = 0.10, weighted scores 67.7 vs. 67.5, p = 0.49) and LDL-C-GRS (unweighted scores 58.5 vs. 58.3, p = 0.34, weighted scores 63.3 vs. 61.1, p = 0.41). The correlation between the CAD-GRS and LDL-C-GRS was low (r = 0.14, p<0.001). In multivariable adjusted regression models, each 1 standard deviation higher values of LDL-C-GRS and CAD-GRS were associated with -0.70 years (95% confidence interval -1.25, -0.14, p = 0.014) and -0.51 years (-1.07, 0.04, p = 0.07) earlier need for revascularization, respectively.

Conclusions: Young individuals presenting with CAD requiring surgical interventions had a higher genetic burden of SNPs relating to LDL-C and CAD (although the latter was statistically non-significant), compared with older individuals. However, the absolute difference was modest, suggesting that genetic screening can currently not be used as an effective prediction tool of when in life a person will develop CAD. Whether undiscovered genetic variants can still explain a “missing heritability” in early-onset CAD warrants more research.

Original languageEnglish
Article numbere0211690
JournalP L o S One
Volume14
Issue number2
Number of pages12
ISSN1932-6203
DOIs
Publication statusPublished - 2019

ID: 213594024