Genome-Wide Association Study in a Lebanese Cohort Confirms PHACTR 1 as a Major Determinant of Coronary Artery Stenosis

The manifestation of coronary artery disease (CAD) follows a well-choreographed series of events that includes damage of arterial endothelial cells and deposition of lipids in the sub-endothelial layers. Genome-wide association studies (GWAS) of multiple populations with distinctive genetic and lifestyle backgrounds are a crucial step in understanding global CAD pathophysiology. In this study, we report a GWAS on the genetic basis of arterial stenosis as measured by cardiac catheterization in a Lebanese population. The locus of the phosphatase and actin regulator 1 gene (PHACTR1) showed association with coronary stenosis in a discovery experiment with genome wide data in 1,949 individuals (rs9349379, OR = 1.37, p = 1.57610). The association was replicated in an additional 2,547 individuals (OR = 1.31, p = 8.85610), leading to genome-wide significant association in a combined analysis (OR = 1.34, p = 8.02610). Results from this GWAS support a central role of PHACTR1 in CAD susceptibility irrespective of lifestyle and ethnic divergences. This association provides a plausible component for understanding molecular mechanisms involved in the formation of stenosis in cardiac vessels and a potential drug target against CAD. Citation: Hager J, Kamatani Y, Cazier J-B, Youhanna S, Ghassibe-Sabbagh M, et al. (2012) Genome-Wide Association Study in a Lebanese Cohort Confirms PHACTR1 as a Major Determinant of Coronary Artery Stenosis. PLoS ONE 7(6): e38663. doi:10.1371/journal.pone.0038663 Editor: Dan Nebert, University of Cincinnati, United States of America Received November 24, 2011; Accepted May 9, 2012; Published June 20, 2012 Copyright: 2012 Hager et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Funding: This work was supported by a grant from the European Commission (FGENTCARD, LSHG-CT-2006-037683). JBC is supported by the Wellcome Trust core award grant number 075491/Z/04. DG held a Wellcome Trust senior fellowship in basic biomedical science (057733). MF is supported by a BHF Clinical Research Excellence award. MGS and PAZ are partly funded by Qatar National Research Fund (QNRF, NPRP 09-215-3-049), JR is partly funded by QNRF (NPRP 4230-1-047). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Competing Interests: DEP is an employee of Bioinformatics and Pattern Discovery, IBM, FR is an employee of IntegraGenSA, Ulla Grove Sidelmann is an employee of Novo Nordisk and Frank Bonner is an employee of Metabometrix Ltd. There are no patents, products in development or marketed products to declare. This does not alter the authors’ adherence to all the PLoS ONE policies on sharing data and materials, as detailed online in the guide for authors. * E-mail: pzalloua@lau.edu.lb . These authors contributed equally to this work. "Members of the FGENTCARD Consortium are listed in the Acknowledgments.

[1]  Jean-Baptiste Cazier,et al.  Large Scale Association Analysis Identifies Three Susceptibility Loci for Coronary Artery Disease , 2011, PloS one.

[2]  Thomas W. Mühleisen,et al.  Large-scale association analysis identifies 13 new susceptibility loci for coronary artery disease , 2011, Nature Genetics.

[3]  Mark I. McCarthy,et al.  A genome-wide association study in Europeans and South Asians identifies five new loci for coronary artery disease , 2011, Nature Genetics.

[4]  Joel N Hirschhorn,et al.  Genome-wide association studies: results from the first few years and potential implications for clinical medicine. , 2011, Annual review of medicine.

[5]  M. McCarthy Genomics, type 2 diabetes, and obesity. , 2010, The New England journal of medicine.

[6]  Jeroen J. Bax,et al.  Predictive Value of Multislice Computed Tomography Variables of Atherosclerosis for Ischemia on Stress-Rest Single-Photon Emission Computed Tomography , 2010, Circulation Cardiovascular Imaging.

[7]  Hae-Young Lee,et al.  Aging and arterial stiffness. , 2010, Circulation journal : official journal of the Japanese Circulation Society.

[8]  Samir Alam,et al.  Parental consanguinity and family history of coronary artery disease strongly predict early stenosis. , 2010, Atherosclerosis.

[9]  Joshua M. Korn,et al.  Genome-wide association of early-onset myocardial infarction with single nucleotide polymorphisms and copy number variants , 2009, Nature Genetics.

[10]  Andrew D. Johnson,et al.  SNAP: a web-based tool for identification and annotation of proxy SNPs using HapMap , 2008, Bioinform..

[11]  B. Bruneau The developmental genetics of congenital heart disease , 2008, Nature.

[12]  R. Collins,et al.  Newly identified loci that influence lipid concentrations and risk of coronary artery disease , 2008, Nature Genetics.

[13]  C. Gieger,et al.  Genomewide association analysis of coronary artery disease. , 2007, The New England journal of medicine.

[14]  T. Michel,et al.  Life history of eNOS: partners and pathways. , 2007, Cardiovascular research.

[15]  Jonathan C. Cohen,et al.  A Common Allele on Chromosome 9 Associated with Coronary Heart Disease , 2007, Science.

[16]  D. Power,et al.  Regulation of endothelial and myocardial NO synthesis by multi-site eNOS phosphorylation. , 2007, Journal of molecular and cellular cardiology.

[17]  D. Reich,et al.  Principal components analysis corrects for stratification in genome-wide association studies , 2006, Nature Genetics.

[18]  T. Gaziano Cardiovascular Disease in the Developing World and Its Cost-Effective Management , 2005, Circulation.

[19]  R. Kloner,et al.  Genetic contributors toward increased risk for ischemic heart disease. , 2005, Journal of molecular and cellular cardiology.

[20]  U. Thorsteinsdóttir,et al.  Association between the gene encoding 5-lipoxygenase-activating protein and stroke replicated in a Scottish population. , 2005, American journal of human genetics.

[21]  S. Yusuf,et al.  Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study , 2004, The Lancet.

[22]  L. Wasserman,et al.  Genomic control, a new approach to genetic-based association studies. , 2001, Theoretical population biology.

[23]  H. Lukkarinen,et al.  Assessment of quality of life with the Nottingham Health Profile among patients with coronary heart disease. , 1997, Journal of advanced nursing.

[24]  L. Berkman,et al.  Genetic susceptibility to death from coronary heart disease in a study of twins. , 1994, The New England journal of medicine.

[25]  J Slack,et al.  The Increased Risk of Death from Ischaemic Heart Disease in First Degree Relatives of 121 Men and 96 Women with Ischaemic Heart Disease , 1966, Journal of medical genetics.

[26]  Tanya M. Teslovich,et al.  Association analyses of 249 , 796 individuals reveal 18 new loci associated with body mass index , 2012 .

[27]  C. Bauters,et al.  [Pathophysiology of coronary artery disease]. , 2008, La Revue du praticien.

[28]  T. Gaziano Reducing the growing burden of cardiovascular disease in the developing world. , 2007, Health affairs.

[29]  S. Azar,et al.  Predictors of coronary artery disease in the Lebanese population. , 2006, Thrombosis research.

[30]  M. Hayden,et al.  ATVB In Focus Role of ABCA1 in Cellular Cholesterol Efflux and Reverse Cholesterol Transport , 2003 .

[31]  W. Schmitz,et al.  Increased expression of cardiac phosphatases in patients with end-stage heart failure. , 1997, Journal of molecular and cellular cardiology.

[32]  W. Willett,et al.  A prospective study of parental history of myocardial infarction and coronary heart disease in women. , 1986, American journal of epidemiology.

[33]  P. McCullagh Regression Models for Ordinal Data , 1980 .