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

Journal article

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: Helgadottir, A; Gretarsdottir, S; Thorleifsson, G; Holm, H; Patel, R

• Publication status: Published
• Journal: Journal of the American College of Cardiology
• Volume: 60
• Issue: 8
• Pages: 722-729
• Publication date: 2012-08-01
• DOI: 10.1016/j.jacc.2012.01.078
• EISSN: 1558-3597
• ISSN: 0735-1097
• Language: English
• Keywords: Severity of Illness Index; Genetic Predisposition to Disease; African Americans; Coronary Artery Disease; European Continental Ancestry Group; Atherosclerosis; Linear Models; Intracranial Aneurysm; Venous Thromboembolism; Odds Ratio; Logistic Models; Risk Factors; Myocardial Infarction; Stroke; Carotid Intima-Media Thickness; Humans; Brain Ischemia; Age of Onset; Angiography; Apolipoproteins A; Peripheral Arterial Disease; Polymorphism, Single Nucleotide; Aortic Aneurysm, Abdominal