Polymorphism of the complement 5 gene and cardiovascular outcome in patients with atherosclerosis
Matthias Hoke1, Walter Speidl, Martin Schillinger
1Department of Internal Medicine II, Division of Angiology, Medical University Vienna, Vienna, Austria. matthias.hoke@meduniwien.ac.at
Insights
The C5 rs17611 GG genotype is linked to higher C5a levels and increased cardiovascular risk in men with carotid atherosclerosis. This finding highlights a genetic risk factor for cardiovascular events in this population.
Area of Science:
- Cardiovascular Science
- Genetics
- Immunology
Background:
- Inflammation, particularly the complement system, plays a role in atherosclerosis.
- A prior study linked the C5 rs17611 single-nucleotide polymorphism (SNP) to stroke.
- The effect of C5 rs17611 on atherosclerosis progression and cardiovascular outcomes in asymptomatic patients was unknown.
Purpose of the Study:
- To investigate the association between the C5 rs17611 polymorphism and cardiovascular outcomes.
- To determine if C5 rs17611 influences the progression of carotid atherosclerosis.
- To explore the relationship between C5 rs17611 and C5a plasma levels.
Main Methods:
- A cohort of 1065 patients with asymptomatic carotid atherosclerosis was studied.
- Patients were followed prospectively for carotid atherosclerosis progression and major adverse cardiovascular events (MACE).
- Genotyping for C5 rs17611 and plasma C5a levels were analyzed.
Main Results:
- The homozygous C5 rs17611 GG genotype was associated with an increased risk of MACE (adjusted HR: 1.36).
- In men, the C5 rs17611 CC genotype was an independent risk factor for MACE (HR 1.50).
- No association was found between C5 rs17611 and carotid stenosis progression, but the variant correlated with C5a plasma levels.
Conclusions:
- The C5 rs17611 GG genotype is linked to elevated C5a plasma levels.
- This genotype represents a risk factor for adverse cardiovascular outcomes, particularly in male patients with carotid atherosclerosis.
Background:
Humoral mediators of inflammation, in particular the complement system, have been described to play an important role in atherogenesis. Previously, we found a single-nucleotide polymorphism (SNP) in the complement 5 gene (C5 rs17611, A>G) independently associated with stroke. Up to now, the impact of C5 rs17611 on the progression of atherosclerosis and cardiovascular outcome in patients with asymptomatic atherosclerosis was unclear.
Materials And Methods:
We investigated C5 rs17611 in a cohort of 1065 consecutive patients with asymptomatic carotid atherosclerosis. All patients were prospectively followed for the progression of carotid atherosclerosis and the development of a first major cardiovascular event (MACE), respectively.
Results:
Three hundred and thirty-seven patients (31·6%) experienced a MACE during a median follow-up of 3·0 years. The homozygous GG genotype of the C5 rs17611 was significantly associated with adverse cardiovascular outcome (adjusted HR: 1·36 [95% CI, 1·07-1·73]; P = 0·01). After stratification for sex, C5 rs17611 CC was found to be an independent risk factor for MACE in men (HR 1·50 [95% CI, 1·12-1·83]). No association of C5 rs17611 with progression of carotid stenosis, observed in 93 (8·7%) patients, was detectable. Performance of ELISA indicated a significant association of the C5 rs17611 variant with C5a plasma levels.
Conclusion:
The C5 rs17611 GG genotype is associated with increased C5a plasma levels and represents a risk factor for adverse cardiovascular outcome in male patients with carotid atherosclerosis.
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