Abstract 4222: Chromosome 9p21 Variant Predicts Mortality After CABG Surgery
Background: Recent genome wide association studies have identified several chromosome 9p21 single nucleotide polymorphisms associated with coronary artery disease and myocardial infarction in non-surgical populations. We have recently demonstrated an independent association between these 9p21 variants and perioperative myocardial injury (PMI) after isolated primary coronary artery bypass graft (CABG) surgery. This study investigated the association of a 9p21 variant with mortality in patients after CABG surgery, and its prognostic value to improve the EuroSCORE.
Methods: In a two-center prospective observational study of 846 Caucasian primary CABG surgery patients, we genotyped rs10116277, the 9p21 variant with the strongest association to PMI in our cohort. To estimate the utility of rs10116277 for predicting within 5 years after surgery, a Cox proportional-hazard model was constructed to estimate the hazard ratios (HRs) and 95% confidence intervals (CI), while adjusting for demographics and clinical covariates.
Results: The homozygote minor allele of rs10116277 was associated with significantly increased risk of mortality even after adjusting for other clinical predictors of mortality in a Cox proportional hazards model (HR 1.7, 95% CI 1.1–2.7, P=0.026). Addition of rs10116277 to the logistic EuroSCORE also significantly improved model prediction for mortality (HR 1.82, 95% CI 1.15–2.88; P=0.01).
Conclusion: The 9p21 variant rs10116277 is independently associated with mortality after primary CABG surgery, and significantly improves the predictive value of the logistic EuroSCORE.