Arrhythmias and conduction disturbance
Usefulness of Single Nucleotide Polymorphism in Chromosome 4q25 to Predict In-Hospital and Long-Term Development of Atrial Fibrillation and Survival in Patients Undergoing Coronary Artery Bypass Grafting

https://doi.org/10.1016/j.amjcard.2011.01.026Get rights and content

We aimed to determine whether polymorphisms in chromosome 4q25 are associated with postoperative atrial fibrillation (AF), long-term AF, postoperative or long-term stroke, and long-term survival after coronary artery bypass grafting. We performed genotyping for rs2200733 and rs10033464 in white participants (n = 1,166) from the TexGen genetic registry. The development of postoperative or long-term AF, postoperative or long-term stroke, and long-term mortality were ascertained. Both rs2200733 and rs10033464 were associated with postoperative AF (odds ratio [OR] 1.41, 95% confidence interval [CI] 1.04 to 1.91, and OR 1.47, 95% CI 1.05 to 2.06, respectively). Carriers of the risk allele (T) had an increased risk of postoperative AF with preoperative β blocker (BB) (for rs2200733, OR 1.47, 95% CI 1.004 to 2.16 for those taking a BB, and OR 1.13, 95% CI 0.73 to 1.73 for those not taking a BB; for rs10033464, OR 1.89, 95% CI 1.22 to 2.93 for those taking preoperative a BB, and OR 1.04, 95% CI 0.65 to 1.65 for those not taking a BB). Both rs2200733 and rs10033464 were also associated with long-term AF (hazard ratio 1.32, 95% CI 1.05 to 1.67, and hazard ratio 1.28, 95% CI 1.00 to 1.66, respectively). Carriers of rs2200733 had increased long-term mortality (hazard ratio 1.57, 95% CI 1.10 to 2.24). These variants were not associated with postoperative or long-term stroke. In conclusion, variants in 4q25 are associated with an increased risk of postoperative or long-term AF and, possibly, mortality in whites undergoing coronary artery bypass grafting, and could potentially affect the choice of therapy used to decrease postoperative AF.

Section snippets

Methods

TexGen is a collaborative, prospective genetic registry that enrolls patients with any personal or family history of cardiovascular disease who seek care at several institutions within the Texas Medical Center system, including the University of Texas Health Science Center, the University of Texas M. D. Anderson Cancer Center, and Baylor College of Medicine and their affiliated hospitals, and the Texas Heart Institute at St. Luke's Episcopal Hospital. The cohort included patients admitted with

Results

Of the patients undergoing CABG enrolled in the TexGen database (n = 1,568), 1,166 patients identified their race as white. This group represented the final population included in the present analyses. The baseline characteristics of these patients are listed in Table 1. The mean age of the cohort was 65 years, and the proportion of men was greater. The prevalence of hypertension and patients with New York Heart Association functional class III-IV symptoms was high, and 10% of the patients

Discussion

In the present prospective analysis from the TexGen cohort, we found that variants in chromosome 4q25 were associated with postoperative AF, the long-term development of AF, and long-term mortality. We also found that the associations between these polymorphisms and postoperative AF could possibly be increased by the use of preoperative BBs.

Our results support the findings from an earlier study that polymorphisms in chromosome 4q25 are associated with the development of postoperative AF.9 The

Acknowledgment

We are extremely grateful to the patients, their families, and the physicians involved in the TexGen study. We also wish to acknowledge Joanna A. Brooks, BA, for her editorial assistance with our report.

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This work was supported by grant 08RDM003 from the Roderick D. MacDonald research fund, St. Luke's Episcopal Hospital (Houston, Texas). Dr. Virani was supported by Career Development Award CDA-09-028 from the Department of Veterans Affairs Health Services Research and Development Service (Washington, DC). This work was also supported by grants National Institutes of Health UL1 RR024148 and 1R01NR010235-01A1 through the TexGen Foundation (Houston, Texas) and funded by the National Institute of Nursing Research (Washington, DC).

The views expressed in this article are those of the authors and do not necessarily represent the views of the Department of Veterans Affairs.

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