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Published on: September 15, 2018
The 9p21.3 locus and cardiovascular risk in familial hypercholesterolemia
Martine Paquette1, Michael Chong2, Yascara Grisel Luna Saavedra1
1Nutrition, Metabolism and Atherosclerosis Clinic, Institut de recherches cliniques de Montréal, Québec, Canada.
Insights
Genetic variants at the 9p21.3 locus increase atherosclerotic cardiovascular disease (ASCVD) risk. This study found the rs1333047 SNP significantly elevates ASCVD susceptibility in familial hypercholesterolemia (FH) patients.
Area of Science:
- Genetics
- Cardiovascular Medicine
- Pharmacogenomics
Background:
- The 9p21.3 locus harbors a significant genetic risk factor for atherosclerotic cardiovascular disease (ASCVD) in the general population.
- The impact of 9p21.3 polymorphisms on ASCVD risk in familial hypercholesterolemia (FH) patients remains unstudied.
Purpose of the Study:
- To investigate the association between the 9p21.3 single nucleotide polymorphism (SNP) rs1333047 and ASCVD susceptibility in FH subjects.
- To determine if genetic screening for rs1333047 can identify high-risk FH patients.
Main Methods:
- Screened 20,434 Caucasian patients with dyslipidemia, including 725 with FH.
- Analyzed the association of the rs1333047 risk allele (T) with ASCVD risk using an additive model.
- Adjusted for traditional cardiovascular risk factors in the analysis.
Main Results:
- Carrying the rs1333047 risk allele was associated with a 42% increased ASCVD susceptibility per allele (OR=1.42; P=.02).
- Individuals with the TT genotype had a higher average number of cardiovascular events (0.83) compared to AA carriers (0.53).
- The mean age of the first ASCVD event did not differ significantly across genotypes.
Conclusions:
- The 9p21.3 SNP rs1333047 is associated with increased ASCVD risk in FH patients.
- Genetic screening for rs1333047 can identify FH individuals at very high risk for ASCVD.
- Early identification may enable more aggressive preventive strategies for high-risk FH patients.
Background:
Carrying a risk variant in the 9p21.3 locus represents one of the strongest genetic risk factors for atherosclerotic cardiovascular disease (ASCVD) in the general population. However, the effect of these polymorphisms in patients with familial hypercholesterolemia (FH) has never been studied.
Objective:
The objective of this study was to investigate the association between the sentinel 9p21.3 single nucleotide polymorphisms (SNP) rs1333047 and ASCVD susceptibility in FH subjects.
Methods:
A total of 20,434 Caucasian patients with dyslipidemia were screened, of which 725 FH were included in this study. The risk allele (T) of the rs1333047 SNP has previously been shown to confer increased ASCVD risk compared with the control allele (A).
Results:
In a model adjusted for traditional cardiovascular risk factors, carrying the risk allele was associated with a 42% increased ASCVD susceptibility per allele, according to an additive model (odds ratio = 1.42; 95% confidence interval, 1.05-1.91; P = .02). On average, 0.53 cardiovascular event was observed in AA carriers, compared with 0.83 in the TT group (P = .02). The mean age of first ASCVD event was similar among the 3 variants.
Conclusion:
The 9p21.3 SNP rs1333047 SNP was associated with increased ASCVD in FH subjects. Genetic screening for this SNP could allow to identify very high risk FH patients, which could benefit from more aggressive ASCVD prevention.
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