Association of the PHACTR1/EDN1 Genetic Locus With Spontaneous Coronary Artery Dissection
David Adlam, Timothy M Olson, Nicolas Combaret, Jason C Kovacic, Siiri E Iismaa, Abtehale Al-Hussaini, Megan M O'Byrne, Sara Bouajila, Adrien Georges, Ketan Mishra, Peter S Braund, Valentina d'Escamard, Siying Huang, Marios Margaritis, Christopher P Nelson, Mariza de Andrade, Daniella Kadian-Dodov, Catherine A Welch, Stephani Mazurkiewicz, Xavier Jeunemaitre, DISCO Consortium, Claire Mei Yi Wong, Eleni Giannoulatou, Michael Sweeting, David Muller, Alice Wood, Lucy McGrath-Cadell, Diane Fatkin, Sally L Dunwoodie, Richard Harvey, Cameron Holloway, Jean-Philippe Empana, Xavier Jouven, CARDIoGRAMPlusC4D Study Group, Jeffrey W Olin, Rajiv Gulati, Marysia S Tweet, Sharonne N Hayes, Nilesh J Samani, Robert M Graham, Pascal Motreff, Nabila Bouatia-Naji, Pascal Motreff, Loïc Belle, Patrick Dupouy, Pierre Barnay, Nicolas Meneveau, Martine Gilard, Gilles Rioufol, Grégoire Range, Philippe Brunel, Nicolas Delarche, Emmanuelle Filippi, Louis Le Bivic, Brahim Harbaoui, Hakim Benamer, Guillaume Cayla, Olivier Varenne, Stephane Peggy Manzo-Silberman, Johanne Silvain, Christian Spaulding, Christophe Caussin, Edouard Gerbaud, Yann Valy, René Koning, Thibault Lhermusier, Stanislas Champin, Emmanuel Salengro, Arnaud Fluttaz, Amer Zabalawi, Yves Cottin, Emmanuel Teiger, Christophe Saint-Etienne, Grégory Ducrocq, Stéphanie Marliere, Emmanuel Boiffard, Pierre Aubry, Jean Louis Georges, Hakim Benamer, Didier Bresson, Fabien De Poli, Gaëtan Karrillon, Vincent Roule, Laurent Bali, Mathieu Valla, Antoine Gerbay, David Houpe, Olivier Dubreuil, Arsène Monnier, Norbert Mayaud, Aurélie Manchuelle, Philippe Commeau, Marc Bedossa, Majid Nikpay, Anuj Goel, Hong-Hee Won, Leanne M Hall, Christina Willenborg, Stavroula Kanoni, Danish Saleheen, Theodosios Kyriakou, Christopher P Nelson, Jemma C Hopewell, Thomas R Webb, Lingyao Zeng, Abbas Dehghan, Maris Alver, Sebastian M Armasu, Kirsi Auro, Andrew Bjonnes, Daniel I Chasman, Shufeng Chen, Ian Ford, Nora Franceschini, Christian Gieger, Christopher Grace, Stefan Gustafsson, Jie Huang, Shih-Jen Hwang, Yun Kyoung Kim, Marcus E Kleber, King Wai Lau, Xiangfeng Lu, Yingchang Lu, Leo P Lyytikäinen, Evelin Mihailov, Alanna Morrison, Natalia Pervjakova, Liming Qu, Lynda M Rose, Elias Salfati, Richa Saxena, Markus Scholz, Albert V Smith, Emmi Tikkanen, Andre Uitterlinden, Xueli Yang, Weihua Zhang, Wei Zhao, Mariza de Andrade, Paul S de Vries, Natalie R van Zuydam, Sonia S Anand, Lars Bertram, Frank Beutner, George Dedoussis, Philippe Frossard, Dominique Gauguier, Alison H Goodall, Omri Gottesman, Marc Haber, Bok-Ghee Han, Jianfeng Huang, Shapour Jalilzadeh, Thorsten Kessler, Inke R König, Lars Lannfelt, Wolfgang Lieb, Lars Lind, Cecilia M Lindgren, Maisa Lokki, Patrik K Magnusson, Nadeem H Mallick, Narinder Mehra, Thomas Meitinger, Fazal-Ur-Rehman Memon, Andrew P Morris, Markku S Nieminen, Nancy L Pedersen, Annette Peters, Loukianos S Rallidis, Asif Rasheed, Maria Samuel, Svati H Shah, Juha Sinisalo, Kathleen E Stirrups, Stella Trompet, Laiyuan Wang, Khan S Zaman, Diego Ardissino, Eric Boerwinkle, Ingrid B Borecki, Erwin P Bottinger, Julie E Buring, John C Chambers, Rory Collins, L Adrienne Cupples, John Danesh, Ilja Demuth, Roberto Elosua, Stephen E Epstein, Tõnu Esko, Mary F Feitosa, Oscar H Franco, Maria Grazia Franzosi, Christopher B Granger, Dongfeng Gu, Vilmundur Gudnason, Alistair S Hall, Anders Hamsten, Tamara B Harris, Stanley L Hazen, Christian Hengstenberg, Albert Hofman, Erik Ingelsson, Carlos Iribarren, J Wouter Jukema, Pekka J Karhunen, Bong-Jo Kim, Jaspal S Kooner, Iftikhar J Kullo, Terho Lehtimäki, Ruth J Loos, Olle Melander, Andres Metspalu, Winfried März, Colin N Palmer, Markus Perola, Thomas Quertermous, Daniel J Rader, Paul M Ridker, Samuli Ripatti, Robert Roberts, Veikko Salomaa, Dharambir K Sanghera, Stephen M Schwartz, Udo Seedorf, Alexandre F Stewart, David J Stott, Joachim Thiery, Pierre A Zalloua, Christopher J O'Donnell, Muredach P Reilly, Themistocles L Assimes, John R Thompson, Jeanette Erdmann, Robert Clarke, Hugh Watkins, Sekar Kathiresan, Ruth McPherson, Panos Deloukas, Heribert Schunkert, Nilesh J Samani, Martin Farrall, David Adlam, Timothy M Olson, Nicolas Combaret, Jason C Kovacic, Siiri E Iismaa, Abtehale Al-Hussaini, Megan M O'Byrne, Sara Bouajila, Adrien Georges, Ketan Mishra, Peter S Braund, Valentina d'Escamard, Siying Huang, Marios Margaritis, Christopher P Nelson, Mariza de Andrade, Daniella Kadian-Dodov, Catherine A Welch, Stephani Mazurkiewicz, Xavier Jeunemaitre, DISCO Consortium, Claire Mei Yi Wong, Eleni Giannoulatou, Michael Sweeting, David Muller, Alice Wood, Lucy McGrath-Cadell, Diane Fatkin, Sally L Dunwoodie, Richard Harvey, Cameron Holloway, Jean-Philippe Empana, Xavier Jouven, CARDIoGRAMPlusC4D Study Group, Jeffrey W Olin, Rajiv Gulati, Marysia S Tweet, Sharonne N Hayes, Nilesh J Samani, Robert M Graham, Pascal Motreff, Nabila Bouatia-Naji, Pascal Motreff, Loïc Belle, Patrick Dupouy, Pierre Barnay, Nicolas Meneveau, Martine Gilard, Gilles Rioufol, Grégoire Range, Philippe Brunel, Nicolas Delarche, Emmanuelle Filippi, Louis Le Bivic, Brahim Harbaoui, Hakim Benamer, Guillaume Cayla, Olivier Varenne, Stephane Peggy Manzo-Silberman, Johanne Silvain, Christian Spaulding, Christophe Caussin, Edouard Gerbaud, Yann Valy, René Koning, Thibault Lhermusier, Stanislas Champin, Emmanuel Salengro, Arnaud Fluttaz, Amer Zabalawi, Yves Cottin, Emmanuel Teiger, Christophe Saint-Etienne, Grégory Ducrocq, Stéphanie Marliere, Emmanuel Boiffard, Pierre Aubry, Jean Louis Georges, Hakim Benamer, Didier Bresson, Fabien De Poli, Gaëtan Karrillon, Vincent Roule, Laurent Bali, Mathieu Valla, Antoine Gerbay, David Houpe, Olivier Dubreuil, Arsène Monnier, Norbert Mayaud, Aurélie Manchuelle, Philippe Commeau, Marc Bedossa, Majid Nikpay, Anuj Goel, Hong-Hee Won, Leanne M Hall, Christina Willenborg, Stavroula Kanoni, Danish Saleheen, Theodosios Kyriakou, Christopher P Nelson, Jemma C Hopewell, Thomas R Webb, Lingyao Zeng, Abbas Dehghan, Maris Alver, Sebastian M Armasu, Kirsi Auro, Andrew Bjonnes, Daniel I Chasman, Shufeng Chen, Ian Ford, Nora Franceschini, Christian Gieger, Christopher Grace, Stefan Gustafsson, Jie Huang, Shih-Jen Hwang, Yun Kyoung Kim, Marcus E Kleber, King Wai Lau, Xiangfeng Lu, Yingchang Lu, Leo P Lyytikäinen, Evelin Mihailov, Alanna Morrison, Natalia Pervjakova, Liming Qu, Lynda M Rose, Elias Salfati, Richa Saxena, Markus Scholz, Albert V Smith, Emmi Tikkanen, Andre Uitterlinden, Xueli Yang, Weihua Zhang, Wei Zhao, Mariza de Andrade, Paul S de Vries, Natalie R van Zuydam, Sonia S Anand, Lars Bertram, Frank Beutner, George Dedoussis, Philippe Frossard, Dominique Gauguier, Alison H Goodall, Omri Gottesman, Marc Haber, Bok-Ghee Han, Jianfeng Huang, Shapour Jalilzadeh, Thorsten Kessler, Inke R König, Lars Lannfelt, Wolfgang Lieb, Lars Lind, Cecilia M Lindgren, Maisa Lokki, Patrik K Magnusson, Nadeem H Mallick, Narinder Mehra, Thomas Meitinger, Fazal-Ur-Rehman Memon, Andrew P Morris, Markku S Nieminen, Nancy L Pedersen, Annette Peters, Loukianos S Rallidis, Asif Rasheed, Maria Samuel, Svati H Shah, Juha Sinisalo, Kathleen E Stirrups, Stella Trompet, Laiyuan Wang, Khan S Zaman, Diego Ardissino, Eric Boerwinkle, Ingrid B Borecki, Erwin P Bottinger, Julie E Buring, John C Chambers, Rory Collins, L Adrienne Cupples, John Danesh, Ilja Demuth, Roberto Elosua, Stephen E Epstein, Tõnu Esko, Mary F Feitosa, Oscar H Franco, Maria Grazia Franzosi, Christopher B Granger, Dongfeng Gu, Vilmundur Gudnason, Alistair S Hall, Anders Hamsten, Tamara B Harris, Stanley L Hazen, Christian Hengstenberg, Albert Hofman, Erik Ingelsson, Carlos Iribarren, J Wouter Jukema, Pekka J Karhunen, Bong-Jo Kim, Jaspal S Kooner, Iftikhar J Kullo, Terho Lehtimäki, Ruth J Loos, Olle Melander, Andres Metspalu, Winfried März, Colin N Palmer, Markus Perola, Thomas Quertermous, Daniel J Rader, Paul M Ridker, Samuli Ripatti, Robert Roberts, Veikko Salomaa, Dharambir K Sanghera, Stephen M Schwartz, Udo Seedorf, Alexandre F Stewart, David J Stott, Joachim Thiery, Pierre A Zalloua, Christopher J O'Donnell, Muredach P Reilly, Themistocles L Assimes, John R Thompson, Jeanette Erdmann, Robert Clarke, Hugh Watkins, Sekar Kathiresan, Ruth McPherson, Panos Deloukas, Heribert Schunkert, Nilesh J Samani, Martin Farrall
Abstract
Background: Spontaneous coronary artery dissection (SCAD) is an increasingly recognized cause of acute coronary syndromes (ACS) afflicting predominantly younger to middle-aged women. Observational studies have reported a high prevalence of extracoronary vascular anomalies, especially fibromuscular dysplasia (FMD) and a low prevalence of coincidental cases of atherosclerosis. PHACTR1/EDN1 is a genetic risk locus for several vascular diseases, including FMD and coronary artery disease, with the putative causal noncoding variant at the rs9349379 locus acting as a potential enhancer for the endothelin-1 (EDN1) gene.
Objectives: This study sought to test the association between the rs9349379 genotype and SCAD.
Methods: Results from case control studies from France, United Kingdom, United States, and Australia were analyzed to test the association with SCAD risk, including age at first event, pregnancy-associated SCAD (P-SCAD), and recurrent SCAD.
Results: The previously reported risk allele for FMD (rs9349379-A) was associated with a higher risk of SCAD in all studies. In a meta-analysis of 1,055 SCAD patients and 7,190 controls, the odds ratio (OR) was 1.67 (95% confidence interval [CI]: 1.50 to 1.86) per copy of rs9349379-A. In a subset of 491 SCAD patients, the OR estimate was found to be higher for the association with SCAD in patients without FMD (OR: 1.89; 95% CI: 1.53 to 2.33) than in SCAD cases with FMD (OR: 1.60; 95% CI: 1.28 to 1.99). There was no effect of genotype on age at first event, P-SCAD, or recurrence.
Conclusions: The first genetic risk factor for SCAD was identified in the largest study conducted to date for this condition. This genetic link may contribute to the clinical overlap between SCAD and FMD.
Keywords: cardiovascular disease in women; fibromuscular dysplasia; genetic association; myocardial infarction.
Copyright © 2019 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
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Source: PubMed