在复制分析中,血栓模块素基因变异与冠状动脉旁路手术后的死亡率增加有关
Robert L Lobato1, William D White, Joseph P Mathew
1Department of Anesthesia, Stanford University School of Medicine, Stanford, CA, USA.
Circulation
|September 14, 2011
概括
血栓模块素 (THBD) 基因中的遗传变异与冠状动脉旁路移植 (CABG) 手术后的较高长期死亡率有关. 这些发现改善了心脏手术患者的风险预测模型.
科学领域:
- 心血管遗传学 心血管遗传学
- 手术结果研究研究.
- 分子流行病学分子流行病学
背景情况:
- 冠状动脉旁路移植 (CABG) 手术后的长期死亡率是一个重大问题.
- 影响血栓和炎症途径的遗传因素可能会影响患者的结果.
- 识别遗传预测因素可以提高CABG患者的风险分层.
研究的目的:
- 研究血栓和炎症途径的遗传变异与CABG后的长期死亡率之间的关联.
- 确定特定的遗传标记,独立预测心脏手术后的死亡风险.
- 评估已识别的遗传变异在改善现有的死亡率预测模型中的有用性.
主要方法:
- 分析了两个独立的CABG患者队列.
- 在49个候选基因中选了90个单核酸多态 (SNP) 的小组.
- 考克斯比例危险模型被用来确定CABG后5年所有原因死亡率的预测因素.
主要成果:
- 血栓模块素 (THBD) 基因的一个常见变异 (rs1042579) 独立地与发现队列中死亡风险增加有关 (HR, 2.26).
- 这种关联在使用链接SNP (rs3176123) (HR, 3.6) 的独立队列中得到了验证.
- 在对临床因素和多次比较进行调整后,这两种变异仍然是显著的预测因素.
结论:
- 在THBD基因中常见的等位基因变异独立地与CABG后的长期死亡风险增加有关.
- 这些遗传标记物显著提高了传统的术后死亡率模型的预测能力.
- 在心脏外科手术中,THBD基因变异代表了改善风险分层的潜在目标.
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