Association of Triglyceride-Related Genetic Variants With Mitral Annular Calcification

Mitral annular calcium (MAC), commonly identified by cardiac imaging, is associated with cardiovascular events and predisposes to the development of clinically important mitral valve regurgitation and mitral valve stenosis. However, its biological determinants remain largely unknown. The authors sou...

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Veröffentlicht in:Journal of the American College of Cardiology Jg. 69; H. 24; S. 2941
Hauptverfasser: Afshar, Mehdi, Luk, Kevin, Do, Ron, Dufresne, Line, Owens, David S, Harris, Tamara B, Peloso, Gina M, Kerr, Kathleen F, Wong, Quenna, Smith, Albert V, Budoff, Mathew J, Rotter, Jerome I, Cupples, L Adrienne, Rich, Stephen S, Engert, James C, Gudnason, Vilmundur, O'Donnell, Christopher J, Post, Wendy S, Thanassoulis, George
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Sprache:Englisch
Veröffentlicht: United States 20.06.2017
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ISSN:1558-3597, 1558-3597
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Abstract Mitral annular calcium (MAC), commonly identified by cardiac imaging, is associated with cardiovascular events and predisposes to the development of clinically important mitral valve regurgitation and mitral valve stenosis. However, its biological determinants remain largely unknown. The authors sought to evaluate whether a genetic predisposition to elevations in plasma lipids is associated with the presence of MAC. The authors used 3 separate Mendelian randomization techniques to evaluate the associations of lipid genetic risk scores (GRS) with MAC in 3 large patient cohorts: the Framingham Health Study, MESA (Multiethnic European Study of Atherosclerosis), and the AGE-RS (Age, Gene/Environment Susceptibility-Reykjavik Study). The authors provided cross-ethnicity replication in the MESA Hispanic-American participants. MAC was present in 1,149 participants (20.4%). In pooled analyses across all 3 cohorts, a triglyceride GRS was significantly associated with the presence of MAC (odds ratio [OR] per triglyceride GRS unit: 1.73; 95% confidence interval [CI]: 1.24 to 2.41; p = 0.0013). Neither low- nor high-density lipoprotein cholesterol GRS was significantly associated with MAC. Results were consistent in cross-ethnicity analyses among the MESA Hispanic-Americans cohort (OR per triglyceride GRS unit: 2.04; 95% CI: 1.03 to 4.03; p = 0.04). In joint meta-analysis across all included cohorts, the triglyceride GRS was associated with MAC (OR per triglyceride GRS unit: 1.79; 95% CI: 1.32 to 2.41; p = 0.0001). The results were robust to several sensitivity analyses that limit both known and unknown forms of genetic pleiotropy. Genetic predisposition to elevated triglyceride levels was associated with the presence of MAC, a risk factor for clinically significant mitral valve disease, suggesting a causal association. Whether reducing triglyceride levels can lower the incidence of clinically significant mitral valve disease requires further study.
AbstractList Mitral annular calcium (MAC), commonly identified by cardiac imaging, is associated with cardiovascular events and predisposes to the development of clinically important mitral valve regurgitation and mitral valve stenosis. However, its biological determinants remain largely unknown. The authors sought to evaluate whether a genetic predisposition to elevations in plasma lipids is associated with the presence of MAC. The authors used 3 separate Mendelian randomization techniques to evaluate the associations of lipid genetic risk scores (GRS) with MAC in 3 large patient cohorts: the Framingham Health Study, MESA (Multiethnic European Study of Atherosclerosis), and the AGE-RS (Age, Gene/Environment Susceptibility-Reykjavik Study). The authors provided cross-ethnicity replication in the MESA Hispanic-American participants. MAC was present in 1,149 participants (20.4%). In pooled analyses across all 3 cohorts, a triglyceride GRS was significantly associated with the presence of MAC (odds ratio [OR] per triglyceride GRS unit: 1.73; 95% confidence interval [CI]: 1.24 to 2.41; p = 0.0013). Neither low- nor high-density lipoprotein cholesterol GRS was significantly associated with MAC. Results were consistent in cross-ethnicity analyses among the MESA Hispanic-Americans cohort (OR per triglyceride GRS unit: 2.04; 95% CI: 1.03 to 4.03; p = 0.04). In joint meta-analysis across all included cohorts, the triglyceride GRS was associated with MAC (OR per triglyceride GRS unit: 1.79; 95% CI: 1.32 to 2.41; p = 0.0001). The results were robust to several sensitivity analyses that limit both known and unknown forms of genetic pleiotropy. Genetic predisposition to elevated triglyceride levels was associated with the presence of MAC, a risk factor for clinically significant mitral valve disease, suggesting a causal association. Whether reducing triglyceride levels can lower the incidence of clinically significant mitral valve disease requires further study.
Mitral annular calcium (MAC), commonly identified by cardiac imaging, is associated with cardiovascular events and predisposes to the development of clinically important mitral valve regurgitation and mitral valve stenosis. However, its biological determinants remain largely unknown.BACKGROUNDMitral annular calcium (MAC), commonly identified by cardiac imaging, is associated with cardiovascular events and predisposes to the development of clinically important mitral valve regurgitation and mitral valve stenosis. However, its biological determinants remain largely unknown.The authors sought to evaluate whether a genetic predisposition to elevations in plasma lipids is associated with the presence of MAC.OBJECTIVESThe authors sought to evaluate whether a genetic predisposition to elevations in plasma lipids is associated with the presence of MAC.The authors used 3 separate Mendelian randomization techniques to evaluate the associations of lipid genetic risk scores (GRS) with MAC in 3 large patient cohorts: the Framingham Health Study, MESA (Multiethnic European Study of Atherosclerosis), and the AGE-RS (Age, Gene/Environment Susceptibility-Reykjavik Study). The authors provided cross-ethnicity replication in the MESA Hispanic-American participants.METHODSThe authors used 3 separate Mendelian randomization techniques to evaluate the associations of lipid genetic risk scores (GRS) with MAC in 3 large patient cohorts: the Framingham Health Study, MESA (Multiethnic European Study of Atherosclerosis), and the AGE-RS (Age, Gene/Environment Susceptibility-Reykjavik Study). The authors provided cross-ethnicity replication in the MESA Hispanic-American participants.MAC was present in 1,149 participants (20.4%). In pooled analyses across all 3 cohorts, a triglyceride GRS was significantly associated with the presence of MAC (odds ratio [OR] per triglyceride GRS unit: 1.73; 95% confidence interval [CI]: 1.24 to 2.41; p = 0.0013). Neither low- nor high-density lipoprotein cholesterol GRS was significantly associated with MAC. Results were consistent in cross-ethnicity analyses among the MESA Hispanic-Americans cohort (OR per triglyceride GRS unit: 2.04; 95% CI: 1.03 to 4.03; p = 0.04). In joint meta-analysis across all included cohorts, the triglyceride GRS was associated with MAC (OR per triglyceride GRS unit: 1.79; 95% CI: 1.32 to 2.41; p = 0.0001). The results were robust to several sensitivity analyses that limit both known and unknown forms of genetic pleiotropy.RESULTSMAC was present in 1,149 participants (20.4%). In pooled analyses across all 3 cohorts, a triglyceride GRS was significantly associated with the presence of MAC (odds ratio [OR] per triglyceride GRS unit: 1.73; 95% confidence interval [CI]: 1.24 to 2.41; p = 0.0013). Neither low- nor high-density lipoprotein cholesterol GRS was significantly associated with MAC. Results were consistent in cross-ethnicity analyses among the MESA Hispanic-Americans cohort (OR per triglyceride GRS unit: 2.04; 95% CI: 1.03 to 4.03; p = 0.04). In joint meta-analysis across all included cohorts, the triglyceride GRS was associated with MAC (OR per triglyceride GRS unit: 1.79; 95% CI: 1.32 to 2.41; p = 0.0001). The results were robust to several sensitivity analyses that limit both known and unknown forms of genetic pleiotropy.Genetic predisposition to elevated triglyceride levels was associated with the presence of MAC, a risk factor for clinically significant mitral valve disease, suggesting a causal association. Whether reducing triglyceride levels can lower the incidence of clinically significant mitral valve disease requires further study.CONCLUSIONSGenetic predisposition to elevated triglyceride levels was associated with the presence of MAC, a risk factor for clinically significant mitral valve disease, suggesting a causal association. Whether reducing triglyceride levels can lower the incidence of clinically significant mitral valve disease requires further study.
Author Rich, Stephen S
Cupples, L Adrienne
Engert, James C
Luk, Kevin
Owens, David S
Budoff, Mathew J
O'Donnell, Christopher J
Smith, Albert V
Gudnason, Vilmundur
Post, Wendy S
Peloso, Gina M
Rotter, Jerome I
Thanassoulis, George
Harris, Tamara B
Kerr, Kathleen F
Wong, Quenna
Afshar, Mehdi
Do, Ron
Dufresne, Line
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  email: george.thanassoulis@mcgill.ca
  organization: Department of Medicine, McGill University, Montreal, Quebec, Canada; Preventive and Genomic Cardiology, McGill University Health Center and Research Institute, Montreal, Quebec, Canada. Electronic address: george.thanassoulis@mcgill.ca
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Keywords mitral valve
lipids
Mendelian randomization
single nucleotide polymorphism
prevention
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References 28619196 - J Am Coll Cardiol. 2017 Jun 20;69(24):2949-2951. doi: 10.1016/j.jacc.2017.04.048.
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Snippet Mitral annular calcium (MAC), commonly identified by cardiac imaging, is associated with cardiovascular events and predisposes to the development of clinically...
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SubjectTerms Aged
Calcinosis - diagnosis
Calcinosis - genetics
Calcinosis - metabolism
Female
Follow-Up Studies
Genetic Predisposition to Disease
Genetic Variation
Humans
Incidence
Male
Middle Aged
Mitral Valve - diagnostic imaging
Mitral Valve Insufficiency - diagnosis
Mitral Valve Insufficiency - genetics
Mitral Valve Insufficiency - metabolism
Polymorphism, Genetic
Prospective Studies
Risk Factors
Tomography, X-Ray Computed
Triglycerides - blood
Triglycerides - genetics
Title Association of Triglyceride-Related Genetic Variants With Mitral Annular Calcification
URI https://www.ncbi.nlm.nih.gov/pubmed/28619195
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