Mutation in APOA1 predicts increased risk of ischaemic heart disease and total mortality without low HDL cholesterol levels
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Mutation in APOA1 predicts increased risk of ischaemic heart disease and total mortality without low HDL cholesterol levels. / Haase, C L; Frikke-Schmidt, R; Nordestgaard, B G; Kateifides, A K; Kardassis, D; Nielsen, Lars Bo; Andersen, C B; Køber, L; Johnsen, A H; Grande, P; Zannis, V I; Tybjaerg-Hansen, A.
I: Journal of Internal Medicine, Bind 270, Nr. 2, 2011, s. 136-46.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Mutation in APOA1 predicts increased risk of ischaemic heart disease and total mortality without low HDL cholesterol levels
AU - Haase, C L
AU - Frikke-Schmidt, R
AU - Nordestgaard, B G
AU - Kateifides, A K
AU - Kardassis, D
AU - Nielsen, Lars Bo
AU - Andersen, C B
AU - Køber, L
AU - Johnsen, A H
AU - Grande, P
AU - Zannis, V I
AU - Tybjaerg-Hansen, A
N1 - © 2011 The Association for the Publication of the Journal of Internal Medicine.
PY - 2011
Y1 - 2011
N2 - OBJECTIVES: To determine whether mutations in APOA1 affect levels of high-density lipoprotein (HDL) cholesterol and to predict risk of ischaemic heart disease (IHD) and total mortality in the general population.BACKGROUND: Epidemiologically, risk of IHD is inversely related to HDL cholesterol levels. Mutations in apolipoprotein (apo) A-I, the major protein constituent of HDL, might be associated with low HDL cholesterol and predispose to IHD and early death.DESIGN: We resequenced APOA1 in 190 individuals and examined the effect of mutations on HDL cholesterol, risk of IHD, myocardial infarction (MI) and mortality in 10 440 individuals in the prospective Copenhagen City Heart Study followed for 31 years. Results were validated in an independent case-control study (n = 16 035). Additionally, we determined plasma ratios of mutant to wildtype (WT) apoA-I in human heterozygotes and functional effects of mutations in adenovirus-transfected mice.RESULTS: We identified a new mutation, A164S (1 : 500 in the general population), which predicted hazard ratios for IHD, MI and total mortality of 3.2 [95% confidence interval (CI): 1.6-6.5], 5.5 (95% CI: 2.6-11.7) and 2.5 (95% CI: 1.3-4.8), respectively, in heterozygotes compared with noncarriers. Mean reduction in survival time in heterozygotes was 10 years (P < 0.0001). Results for IHD and MI were confirmed in the case-control study. Furthermore, the ratio of mutant S164 to WT A164 apoA-I in plasma of heterozygotes was reduced. In addition, A164S heterozygotes had normal plasma lipid and lipoprotein levels, including HDL cholesterol and apoA-I, and this finding was confirmed in adenovirus-transfected mice.CONCLUSIONS: A164S is the first mutation in APOA1 to be described that predicts an increased risk of IHD, MI and total mortality without low HDL cholesterol levels.
AB - OBJECTIVES: To determine whether mutations in APOA1 affect levels of high-density lipoprotein (HDL) cholesterol and to predict risk of ischaemic heart disease (IHD) and total mortality in the general population.BACKGROUND: Epidemiologically, risk of IHD is inversely related to HDL cholesterol levels. Mutations in apolipoprotein (apo) A-I, the major protein constituent of HDL, might be associated with low HDL cholesterol and predispose to IHD and early death.DESIGN: We resequenced APOA1 in 190 individuals and examined the effect of mutations on HDL cholesterol, risk of IHD, myocardial infarction (MI) and mortality in 10 440 individuals in the prospective Copenhagen City Heart Study followed for 31 years. Results were validated in an independent case-control study (n = 16 035). Additionally, we determined plasma ratios of mutant to wildtype (WT) apoA-I in human heterozygotes and functional effects of mutations in adenovirus-transfected mice.RESULTS: We identified a new mutation, A164S (1 : 500 in the general population), which predicted hazard ratios for IHD, MI and total mortality of 3.2 [95% confidence interval (CI): 1.6-6.5], 5.5 (95% CI: 2.6-11.7) and 2.5 (95% CI: 1.3-4.8), respectively, in heterozygotes compared with noncarriers. Mean reduction in survival time in heterozygotes was 10 years (P < 0.0001). Results for IHD and MI were confirmed in the case-control study. Furthermore, the ratio of mutant S164 to WT A164 apoA-I in plasma of heterozygotes was reduced. In addition, A164S heterozygotes had normal plasma lipid and lipoprotein levels, including HDL cholesterol and apoA-I, and this finding was confirmed in adenovirus-transfected mice.CONCLUSIONS: A164S is the first mutation in APOA1 to be described that predicts an increased risk of IHD, MI and total mortality without low HDL cholesterol levels.
KW - Adult
KW - Aged
KW - Animals
KW - Apolipoprotein A-I
KW - Case-Control Studies
KW - Denmark
KW - Female
KW - Humans
KW - Lipoproteins, HDL
KW - Male
KW - Mice
KW - Middle Aged
KW - Mutation
KW - Myocardial Ischemia
KW - Risk Factors
KW - Sequence Analysis, DNA
KW - Survival Analysis
U2 - 10.1111/j.1365-2796.2011.02381.x
DO - 10.1111/j.1365-2796.2011.02381.x
M3 - Journal article
C2 - 21443680
VL - 270
SP - 136
EP - 146
JO - Acta Medica Scandinavica
JF - Acta Medica Scandinavica
SN - 0955-7873
IS - 2
ER -
ID: 38432041