Apolipoprotein(a) genetic sequence variants associated with systemic atherosclerosis and coronary atherosclerotic burden but not with venous thromboembolism.

Abstract

OBJECTIVES:

The purpose of this study is investigate the effects of variants in the apolipoprotein(a) gene (LPA) on vascular diseases with different atherosclerotic and thrombotic components.

BACKGROUND:

It is unclear whether the LPA variants rs10455872 and rs3798220, which correlate with lipoprotein(a) levels and coronary artery disease (CAD), confer susceptibility predominantly via atherosclerosis or thrombosis.

METHODS:

The 2 LPA variants were combined and examined as LPA scores for the association with ischemic stroke (and TOAST [Trial of Org 10172 in Acute Stroke Treatment] subtypes) (effective sample size [n(e)] = 9,396); peripheral arterial disease (n(e) = 5,215); abdominal aortic aneurysm (n(e) = 4,572); venous thromboembolism (n(e) = 4,607); intracranial aneurysm (n(e) = 1,328); CAD (n(e) = 12,716), carotid intima-media thickness (n = 3,714), and angiographic CAD severity (n = 5,588).

RESULTS:

LPA score was associated with ischemic stroke subtype large artery atherosclerosis (odds ratio [OR]: 1.27; p = 6.7 × 10(-4)), peripheral artery disease (OR: 1.47; p = 2.9 × 10(-14)), and abdominal aortic aneurysm (OR: 1.23; p = 6.0 × 10(-5)), but not with the ischemic stroke subtypes cardioembolism (OR: 1.03; p = 0.69) or small vessel disease (OR: 1.06; p = 0.52). Although the LPA variants were not associated with carotid intima-media thickness, they were associated with the number of obstructed coronary vessels (p = 4.8 × 10(-12)). Furthermore, CAD cases carrying LPA risk variants had increased susceptibility to atherosclerotic manifestations outside of the coronary tree (OR: 1.26; p = 0.0010) and had earlier onset of CAD (-1.58 years/allele; p = 8.2 × 10(-8)) than CAD cases not carrying the risk variants. There was no association of LPA score with venous thromboembolism (OR: 0.97; p = 0.63) or intracranial aneurysm (OR: 0.85; p = 0.15).

CONCLUSIONS:

LPA sequence variants were associated with atherosclerotic burden, but not with primarily thrombotic phenotypes.

• Authors: Anna Helgadottir, Solveig Gretarsdottir, Gudmar Thorleifsson, Hilma Holm, Riyaz S Patel, Thorarinn Gudnason, Gregory T Jones, Andre M van Rij, Danny J Eapen, Annette F Baas, David-Alexandre Tregouet, Pierre-Emmanuel Morange, Joseph Emmerich, Bengt Lindblad, Anders Gottsäter, Lambertus A Kiemeny, Jes S Lindholt, Natzi Sakalihasan, Robert E Ferrell, David J Carey, James R Elmore, Philip S Tsao, Niels Grarup, Torben Jørgensen, Daniel R Witte, Torben Hansen, Oluf Pedersen, Roberto Pola, Eleonora Gaetani, Hulda B Magnadottir, Cisca Wijmenga, Gerard Tromp, Antti Ronkainen, Ynte M Ruigrok, Jan D Blankensteijn, Thomas Mueller, Philip S Wells, Javier Corral, Jose Manuel Soria, Juan Carlos Souto, John F Peden, Shapour Jalilzadeh, Bongani M Mayosi, Bernard Keavney, Rona J Strawbridge, Maria Sabater-Lleal, Karl Gertow, Damiano Baldassarre, Kristiina Nyyssönen, Rainer Rauramaa, Andries J Smit, Elmo Mannarino, Philippe Giral, Elena Tremoli, Ulf de Faire, Steve E Humphries, Anders Hamsten, Vilhelmina Haraldsdottir, Isleifur Olafsson, Magnus K Magnusson, Nilesh J Samani, Allan I Levey, Hugh S Markus, Konstantinos Kostulas, Martin Dichgans, Klaus Berger, Gregor Kuhlenbäumer, E Bernd Ringelstein, Monika Stoll, Udo Seedorf, Peter M Rothwell, Janet T Powell, Helena Kuivaniemi, Pall T Onundarson, Einar Valdimarsson, Stefan E Matthiasson, Daniel F Gudbjartsson, Guðmundur Thorgeirsson, Arshed A Quyyumi, Hugh Watkins, Martin Farrall, Unnur Thorsteinsdottir, Kari Stefansson
• Journal: Journal of the American College of Cardiology (J Am Coll Cardiol) Vol. 60 Issue 8 Pg. 722-9 (Aug 21 2012) ISSN: 1558-3597 [Electronic] United States
• PMID: 22898070 (Publication Type: Journal Article, Meta-Analysis, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Chemical References

• Apolipoproteins A

Topics

• Black or African American (genetics)
• Age of Onset
• Angiography
• Aortic Aneurysm, Abdominal (genetics)
• Apolipoproteins A (genetics)
• Atherosclerosis (genetics)
• Brain Ischemia (genetics)
• Carotid Intima-Media Thickness
• Coronary Artery Disease (genetics)
• Genetic Predisposition to Disease
• Humans
• Intracranial Aneurysm (genetics)
• Linear Models
• Logistic Models
• Myocardial Infarction (genetics)
• Odds Ratio
• Peripheral Arterial Disease (genetics)
• Polymorphism, Single Nucleotide
• Risk Factors
• Severity of Illness Index
• Stroke (genetics)
• Venous Thromboembolism (genetics)
• White People (genetics)