Abstract P124: The Relationship Between the AGTR1-A1166C Polymorphism With Implantable Cardiac Defribrillator Therapies in Patients With Chronic Heart Failure
INTRODUCTION: Sudden cardiac death (SCD) accounts for approximately 350,000 annual deaths in the United States. It is not known whether polymorphisms in genes that affect prognosis and survival in heart failure would modify arrhythmic risk and SCD. We hypothesized that carriers of the Angiotensin Receptor Type 1 (AGTR1) A1166C polymorphism would have a higher incidence of ventricular arrhythmias requiring implantable cardiac defibrillator (ICD) therapies.
METHODS: Utilizing a database of consecutive ICD patients at the Atlanta Veterans Affairs Medical Center and Emory University Hospital from 2005–2009, we tested the association between the AGTR1-A1166C polymorphism with presence and frequency of antitachycardial pacing (ATP) and ICD shocks in a cohort of 500 patients. Appropriateness of therapies was evaluated at time of ICD interrogations. Patients who did not receive an ICD intervention served as the control group. Genomic DNA was isolated from whole blood by standard techniques utilizing the QIAamp® Blood Kit (Qiagen, Inc.). Pyrosequencing was utilized to identify the AGTR1-A1166C polymorphism. Comparisons were analyzed by chi-square statistics and logistic regression.
RESULTS: Patients with AGTR1–1166 CC genotype had an increased incidence of all events: ATP plus ICD shocks (p=0.027). Hardy Weinberg equilibrium was maintained and results were controlled for race.
CONCLUSION: Our study suggests that the AGTR1–1166CC genotype is associated with increased ICD therapies and therefore, carriers of the CC genotype are at higher risk for ventricular arrhythmias.