染色体9p21变异预测冠状动脉旁路移植手术后的死亡率
Jochen D Muehlschlegel1, Kuang-Yu Liu, Tjörvi E Perry
1Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA. jmuehlschlegel@partners.org.
Circulation
|September 15, 2010
概括
染色体9p21上的特定基因变异 (rs10116277) 与冠状动脉旁路移植 (CABG) 手术后的死亡风险增加有关. 这一发现提高了CABG患者风险预测模型的准确性.
科学领域:
- 遗传学 是一个遗传学.
- 心血管外科心血管外科
- 基因组学就是基因组学.
背景情况:
- 全基因组关联研究确定了与冠状动脉疾病相关的9p21染色体单核酸多态 (SNP).
- 以前的研究表明,在冠状动脉旁路移植 (CABG) 手术后,9p21变体和外科手术期间心肌损伤之间存在联系.
研究的目的:
- 为了研究特定的9p21变体 (rs10116277) 与CABG手术后患者的死亡风险之间的关联.
- 评估rs10116277的预测值,以提高EuroSCORE风险评估工具的预测准确度.
主要方法:
- 一项前性观察性研究,涉及846名接受初级CABG手术的白人患者.
- 对rs10116277变体的基因型定型和使用Cox比例危险模型进行分析,以预测5年全因死亡率.
- 评估 rs10116277 对物流EuroSCORE模型预测性能的影响.
主要成果:
- rs10116277的同位素小等位基因与CABG后全因死亡风险增加显著相关 (HR,1.7;95% CI,1.1-2.7;P=0.026),即使经过对其他临床因素进行调整.
- 将rs10116277纳入后勤EuroSCORE模型显著改善了其死亡率预测 (HR,1.82;95% CI,1.15-2.88;P=0.01).
结论:
- 9p21变种rs10116277是接受初级CABG手术的白人患者全因死亡率的独立预测因子.
- 这种遗传标记增强了后CABG死亡率的后勤EuroSCORE的预测能力.
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