TY - JOUR
T1 - Angiotensinogen and ACE gene polymorphisms and risk of atrial fibrillation in the general population.
AU - Ravn, Lasse S
AU - Benn, Marianne
AU - Nordestgaard, Børge G
AU - Sethi, Amar A
AU - Agerholm-Larsen, Birgit
AU - Jensen, Gorm B
AU - Tybjærg-Hansen, Anne
PY - 2008
Y1 - 2008
N2 - OBJECTIVES: The renin-angiotensin system may play a role in the pathogenesis of atrial fibrillation, and renin-angiotensin system blockers reduce the risk of atrial fibrillation. We hypothesized that polymorphisms in the angiotensinogen and angiotensin-converting enzyme (ACE) genes encoding proteins in this system predict risk of atrial fibrillation. METHODS AND RESULTS: We genotyped 9235 individuals from the Danish general population, The Copenhagen City Heart Study, for the a-20c, g-6a, T174M, and M235T polymorphisms in the angiotensinogen gene and the insertion/deletion (I/D) polymorphism in the ACE gene; rare allele frequencies were 0.16, 0.40, 0.12, 0.41, and 0.49, respectively. Participants had sinus rhythm at inclusion. During 26 years of follow-up, 968 individuals developed atrial fibrillation. Multifactorially adjusted hazard ratios for atrial fibrillation for a-20c ac and cc versus aa genotype were 1.1(95% confidence interval: 1.0-1.3; P=0.05) and 1.5(1.1-2.1; P=0.01). Compared with double noncarriers (angiotensinogen -20aa and ACE II), double heterozygotes (ac-I/D genotype), and double homozygotes (cc-DD) had hazard ratios for atrial fibrillation of 1.2(0.9-1.6; P=0.06) and 2.4(1.4-4.1; P=0.001). a-20c cc homozygotes above 70 years of age who were overweight, severely hypertensive, and had heart failure, had an absolute 10-year risk of atrial fibrillation of 61%. CONCLUSION: Angiotensinogen a-20c genotype alone and in combination with ACE I/D genotype predicts an increased risk of atrial fibrillation. Therefore, genetic variation in the renin-angiotensin system may influence effect of renin-angiotensin system blockers on atrial fibrillation.
AB - OBJECTIVES: The renin-angiotensin system may play a role in the pathogenesis of atrial fibrillation, and renin-angiotensin system blockers reduce the risk of atrial fibrillation. We hypothesized that polymorphisms in the angiotensinogen and angiotensin-converting enzyme (ACE) genes encoding proteins in this system predict risk of atrial fibrillation. METHODS AND RESULTS: We genotyped 9235 individuals from the Danish general population, The Copenhagen City Heart Study, for the a-20c, g-6a, T174M, and M235T polymorphisms in the angiotensinogen gene and the insertion/deletion (I/D) polymorphism in the ACE gene; rare allele frequencies were 0.16, 0.40, 0.12, 0.41, and 0.49, respectively. Participants had sinus rhythm at inclusion. During 26 years of follow-up, 968 individuals developed atrial fibrillation. Multifactorially adjusted hazard ratios for atrial fibrillation for a-20c ac and cc versus aa genotype were 1.1(95% confidence interval: 1.0-1.3; P=0.05) and 1.5(1.1-2.1; P=0.01). Compared with double noncarriers (angiotensinogen -20aa and ACE II), double heterozygotes (ac-I/D genotype), and double homozygotes (cc-DD) had hazard ratios for atrial fibrillation of 1.2(0.9-1.6; P=0.06) and 2.4(1.4-4.1; P=0.001). a-20c cc homozygotes above 70 years of age who were overweight, severely hypertensive, and had heart failure, had an absolute 10-year risk of atrial fibrillation of 61%. CONCLUSION: Angiotensinogen a-20c genotype alone and in combination with ACE I/D genotype predicts an increased risk of atrial fibrillation. Therefore, genetic variation in the renin-angiotensin system may influence effect of renin-angiotensin system blockers on atrial fibrillation.
KW - Adult
KW - Aged
KW - Alleles
KW - Amino Acid Sequence
KW - Angiotensinogen
KW - Atrial Fibrillation
KW - Base Sequence
KW - DNA
KW - Denmark
KW - Female
KW - Genetic Predisposition to Disease
KW - Heterozygote
KW - Homozygote
KW - Humans
KW - Linkage Disequilibrium
KW - Longitudinal Studies
KW - Male
KW - Middle Aged
KW - Molecular Sequence Data
KW - Peptidyl-Dipeptidase A
KW - Pharmacogenetics
KW - Polymorphism, Genetic
KW - Renin-Angiotensin System
KW - Risk Factors
KW - Sequence Homology, Amino Acid
KW - Sequence Homology, Nucleic Acid
U2 - 10.1097/FPC.0b013e3282fce3bd
DO - 10.1097/FPC.0b013e3282fce3bd
M3 - Journal article
C2 - 18496132
SN - 1744-6872
VL - 18
SP - 525
EP - 533
JO - Pharmacogenetics and Genomics
JF - Pharmacogenetics and Genomics
IS - 6
ER -