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Circulation Topic Review

Genetics of Coronary Artery Disease

Wolfgang Lieb, Ramachandran S. Vasan
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https://doi.org/10.1161/CIRCULATIONAHA.113.005350
Circulation. 2013;128:1131-1138
Originally published September 3, 2013
Wolfgang Lieb
From the Institute of Epidemiology, Christian Albrechts Universität Kiel, Kiel, Germany (W.L.); The Framingham Heart Study, Framingham, MA (R.S.V.); and Boston University School of Medicine, Section of Preventive Medicine (R.S.V.).
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Ramachandran S. Vasan
From the Institute of Epidemiology, Christian Albrechts Universität Kiel, Kiel, Germany (W.L.); The Framingham Heart Study, Framingham, MA (R.S.V.); and Boston University School of Medicine, Section of Preventive Medicine (R.S.V.).
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    • Introduction
    • Main Results From GWAS and Recent Gene-Centric Approaches
    • Genetic Predictors in Patients With Established CAD
    • Impact of CAD Phenotype Definition on Effect Estimates in Genetic Association Studies
    • Functional Workup of GWAS Results
    • Use of Genetic Information for Risk Prediction and Assessment of Clinical Utility
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Introduction

Coronary heart disease affects ≈15.4 million individuals in the United States1 and is one of the main causes of mortality and morbidity.1 A familial component contributes to cardiovascular disease (CVD) susceptibility,2 but it was not until the emergence of genomewide association studies (GWAS) that genetic loci were identified that displayed consistent associations with coronary artery disease (CAD) across multiple cohorts. The present article describes recent advances in the understanding of the genetic basis of CAD.

Main Results From GWAS and Recent Gene-Centric Approaches

Family2 and twin3 studies provided convincing evidence that CAD clusters in families and has a heritable component2–5; however, the delineation of the specific genetic architecture that predisposes to CAD has been challenging, with initial candidate gene approaches yielding inconsistent results.6 In contrast to candidate gene approaches that focus on genetic variation in genes whose gene products are known to play an important role in cardiovascular physiology, GWAS simultaneously assess the association with CAD of hundreds of thousands of genetic variants distributed across the whole genome. Therefore, GWAS represent an essentially unbiased approach that is not limited by the current (patho)physiological understanding of CVD and bears the potential of discovering completely new molecular mechanisms that predispose to CAD.

In 2007, the first GWAS for CAD were published.7–9 The main finding was a locus on chromosome 9p21, which is still the most consistently associated CAD locus to date.10 Subsequent studies revealed that this locus is related to a broad spectrum of vascular phenotypes, including CAD and myocardial infarction,7–9 coronary artery calcification,11 peripheral artery disease,12,13 and abdominal aortic aneurysm.14 To increase power for the detection of genetic variants with smaller effect sizes, large consortia have been built that combine genetic-epidemiological data from multiple cohorts and tens …

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Circulation
September 3, 2013, Volume 128, Issue 10
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  • Article
    • Introduction
    • Main Results From GWAS and Recent Gene-Centric Approaches
    • Genetic Predictors in Patients With Established CAD
    • Impact of CAD Phenotype Definition on Effect Estimates in Genetic Association Studies
    • Functional Workup of GWAS Results
    • Use of Genetic Information for Risk Prediction and Assessment of Clinical Utility
    • Conclusions
    • Sources of Funding
    • Disclosures
    • References
  • Figures & Tables
  • Info & Metrics
  • eLetters

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    Genetics of Coronary Artery Disease
    Wolfgang Lieb and Ramachandran S. Vasan
    Circulation. 2013;128:1131-1138, originally published September 3, 2013
    https://doi.org/10.1161/CIRCULATIONAHA.113.005350

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    Genetics of Coronary Artery Disease
    Wolfgang Lieb and Ramachandran S. Vasan
    Circulation. 2013;128:1131-1138, originally published September 3, 2013
    https://doi.org/10.1161/CIRCULATIONAHA.113.005350
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