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Meta-analysis identifies six new susceptibility loci for atrial fibrillation

Abstract

Atrial fibrillation is a highly prevalent arrhythmia and a major risk factor for stroke, heart failure and death1. We conducted a genome-wide association study (GWAS) in individuals of European ancestry, including 6,707 with and 52,426 without atrial fibrillation. Six new atrial fibrillation susceptibility loci were identified and replicated in an additional sample of individuals of European ancestry, including 5,381 subjects with and 10,030 subjects without atrial fibrillation (P < 5 × 10−8). Four of the loci identified in Europeans were further replicated in silico in a GWAS of Japanese individuals, including 843 individuals with and 3,350 individuals without atrial fibrillation. The identified loci implicate candidate genes that encode transcription factors related to cardiopulmonary development, cardiac-expressed ion channels and cell signaling molecules.

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Figure 1: Manhattan plot of meta-analysis results for genome-wide association with atrial fibrillation.
Figure 2: Regional plots for seven new atrial fibrillation loci in the discovery sample with P < 1 × 10−8.

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References

  1. Fuster, V. et al. ACC/AHA/ESC 2006 Guidelines for the Management of Patients with Atrial Fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation): developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society. Circulation 114, e257–e354 (2006).

    Article  Google Scholar 

  2. Ellinor, P.T. et al. Common variants in KCNN3 are associated with lone atrial fibrillation. Nat. Genet. 42, 240–244 (2010).

    Article  CAS  Google Scholar 

  3. Benjamin, E.J. et al. Variants in ZFHX3 are associated with atrial fibrillation in individuals of European ancestry. Nat. Genet. 41, 879–881 (2009).

    Article  CAS  Google Scholar 

  4. Gudbjartsson, D.F. et al. Variants conferring risk of atrial fibrillation on chromosome 4q25. Nature 448, 353–357 (2007).

    Article  CAS  Google Scholar 

  5. Gudbjartsson, D.F. et al. A sequence variant in ZFHX3 on 16q22 associates with atrial fibrillation and ischemic stroke. Nat. Genet. 41, 876–878 (2009).

    Article  CAS  Google Scholar 

  6. Pfeufer, A. et al. Genome-wide association study of PR interval. Nat. Genet. 42, 153–159 (2010).

    Article  CAS  Google Scholar 

  7. Holm, H. et al. Several common variants modulate heart rate, PR interval and QRS duration. Nat. Genet. 42, 117–122 (2010).

    Article  CAS  Google Scholar 

  8. Lubitz, S.A. et al. Association between familial atrial fibrillation and risk of new-onset atrial fibrillation. J. Am. Med. Assoc. 304, 2263–2269 (2010).

    Article  CAS  Google Scholar 

  9. Bergwerff, M. et al. Loss of function of the Prx1 and Prx2 homeobox genes alters architecture of the great elastic arteries and ductus arteriosus. Virchows Arch. 436, 12–19 (2000).

    Article  CAS  Google Scholar 

  10. Ihida-Stansbury, K. et al. Paired-related homeobox gene Prx1 is required for pulmonary vascular development. Circ. Res. 94, 1507–1514 (2004).

    Article  CAS  Google Scholar 

  11. Volonte, D., McTiernan, C.F., Drab, M., Kasper, M. & Galbiati, F. Caveolin-1 and caveolin-3 form heterooligomeric complexes in atrial cardiac myocytes that are required for doxorubicin-induced apoptosis. Am. J. Physiol. Heart Circ. Physiol. 294, H392–H401 (2008).

    Article  CAS  Google Scholar 

  12. Zhao, Y.Y. et al. Defects in caveolin-1 cause dilated cardiomyopathy and pulmonary hypertension in knockout mice. Proc. Natl. Acad. Sci. USA 99, 11375–11380 (2002).

    Article  CAS  Google Scholar 

  13. Lin, J. et al. The regulation of the cardiac potassium channel (HERG) by caveolin-1. Biochem. Cell Biol. 86, 405–415 (2008).

    Article  CAS  Google Scholar 

  14. Sinner, M.F. et al. The non-synonymous coding IKr-channel variant KCNH2-K897T is associated with atrial fibrillation: results from a systematic candidate gene-based analysis of KCNH2 (HERG). Eur. Heart J. 29, 907–914 (2008).

    Article  CAS  Google Scholar 

  15. Zhang, Q. et al. Nesprin-1 and -2 are involved in the pathogenesis of Emery Dreifuss muscular dystrophy and are critical for nuclear envelope integrity. Hum. Mol. Genet. 16, 2816–2833 (2007).

    Article  CAS  Google Scholar 

  16. Matsuura, T. et al. Two newly identified genomic mutations in a Japanese female patient with fructose-1,6-bisphosphatase (FBPase) deficiency. Mol. Genet. Metab. 76, 207–210 (2002).

    Article  CAS  Google Scholar 

  17. Schulze-Bahr, E. et al. Pacemaker channel dysfunction in a patient with sinus node disease. J. Clin. Invest. 111, 1537–1545 (2003).

    Article  CAS  Google Scholar 

  18. Milanesi, R., Baruscotti, M., Gnecchi-Ruscone, T. & DiFrancesco, D. Familial sinus bradycardia associated with a mutation in the cardiac pacemaker channel. N. Engl. J. Med. 354, 151–157 (2006).

    Article  CAS  Google Scholar 

  19. Frey, N. & Olson, E.N. Calsarcin-3, a novel skeletal muscle–specific member of the calsarcin family, interacts with multiple Z-disc proteins. J. Biol. Chem. 277, 13998–14004 (2002).

    Article  CAS  Google Scholar 

  20. Beqqali, A. et al. CHAP is a newly identified Z-disc protein essential for heart and skeletal muscle function. J. Cell Sci. 123, 1141–1150 (2010).

    Article  Google Scholar 

  21. Arola, A.M. et al. Mutations in PDLIM3 and MYOZ1 encoding myocyte Z line proteins are infrequently found in idiopathic dilated cardiomyopathy. Mol. Genet. Metab. 90, 435–440 (2007).

    Article  CAS  Google Scholar 

  22. Brugada, R. et al. Identification of a genetic locus for familial atrial fibrillation. N. Engl. J. Med. 336, 905–911 (1997).

    Article  CAS  Google Scholar 

  23. Lubitz, S.A. et al. Independent susceptibility markers for atrial fibrillation on chromosome 4q25. Circulation 122, 976–984 (2010).

    Article  CAS  Google Scholar 

  24. Kääb, S. et al. Large scale replication and meta-analysis of variants on chromosome 4q25 associated with atrial fibrillation. Eur. Heart J. 30, 813–819 (2009).

    Article  Google Scholar 

  25. Stranger, B.E. et al. Population genomics of human gene expression. Nat. Genet. 39, 1217–1224 (2007).

    Article  CAS  Google Scholar 

  26. Vasan, R.S. et al. Genetic variants associated with cardiac structure and function: a meta-analysis and replication of genome-wide association data. J. Am. Med. Assoc. 302, 168–178 (2009).

    Article  CAS  Google Scholar 

  27. Johnson, A.D. et al. SNAP: a web-based tool for identification and annotation of proxy SNPs using HapMap. Bioinformatics 24, 2938–2939 (2008).

    Article  CAS  Google Scholar 

  28. Price, A.L. et al. Principal components analysis corrects for stratification in genome-wide association studies. Nat. Genet. 38, 904–909 (2006).

    Article  CAS  Google Scholar 

  29. de Bakker, P.I. et al. Practical aspects of imputation-driven meta-analysis of genome-wide association studies. Hum. Mol. Genet. 17, R122–R128 (2008).

    Article  CAS  Google Scholar 

  30. International HapMap Consortium. The International HapMap Project. Nature 426, 789–796 (2003).

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Acknowledgements

Acknowledgments are contained in the Supplementary Note.

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Study concept and design was determined by P.T.E., K.L.L., C.M.A., B.P.K., M.K.C., J.D., H.V., A.H., Y.N., D.M.R., A.G.U., A.B.N., Y.L., T. Tanaka, B.H.C.S., S.B.F., D.D., S.R.H., E.J.B., V.G. and S. Kääb. Acquisition of data was performed by P.T.E., C.M.A., N.L.G., J.C.B., M.K.C., M.D., J.D.R., A.P., M.F.S., J.D., N.L.S., J.D.S., R.W., J.I.R., L.J.L., T.B.H., U.V., A.H., E.Z.S., M.K., U.B.T., D.C., T.F., R.M., B.M.P., T.M., S.P., H.-E.W., J.C.M.W., A.G.U., F.R., M.S., A.B.N., Y.L., M.H.G., B.H.C.S., A.A., S.R.H., E.J.B., V.G., B.P., H.L., B.F.V., M.B., W.H.L.K. and S. Kääb. Analysis and interpretation of data were performed by P.T.E., K.L.L., N.L.G., M.D.R., A.V.S., D.E.A., M.M.-N., B.P.K., S.A.L., J.C.B., M.D., K.O., J.D.R., J.G.S., M.F.S., K.L., J.D., N.L.S., K.M.R., J.I.R., R.W.D., U.V., G.L., T. Tsunoda, N.S., N.K., B.M.P., S. Kathiresan, D.M.R., B.M., Y.L., M.H.G., D.D., S.R.H., H.L., S.X. and E.J.B. Drafting of the manuscript was carried out by P.T.E., K.L.L., B.P.K., S.A.L. and S. Kääb. Critical revision of the manuscript for important intellectual content was carried out by C.M.A., N.L.G., A.V.S., D.E.A., B.P.K., J.C.B., M.K.C., M.D., J.G.S., A.P., M.F.S., J.D., N.L.S., J.D.S., M.R., K.M.R., D.R.V.W., J.W.M., R.W., J.I.R., L.J.L., T.B.H., U.V., H.V., D.J.M., A.H., L.Y.C., E.Z.S., G.L., U.B.T., P.M.R., D.C., N.S., S.M., K.L.F., B.M.P., T.M., S.P., J.C.M.W., D.M.R., A.G.U., F.R., B.M., M.S., A.B.N., Y.L., M.H.G., O.M., B.H.C.S., S.B.F., A.A., D.D., D.I.C., S.R.H., E.J.B., G.S., S.C., A.C., D.L., J.R. and V.G. Statistical analysis was performed by K.L.L., N.L.G., M.D.R., A.V.S., D.E.A., M.M.-N., B.P.K., J.C.B., J.G.S., M.F.S., K.L., J.D., K.M.R., R.W.D., U.V., G.L., L.M.R., Y.L. and D.I.C. Funding was obtained by P.T.E., C.M.A., M.K.C., J.G.S., N.L.S., J.D.S., J.I.R., L.J.L., T.B.H., H.V., A.H., E.B., U.B.T., P.M.R., B.M.P., T.M., H.-E.W., J.C.M.W., D.M.R., A.G.U., Y.L., O.M., B.H.C.S., S.B.F., A.A., D.D., S.R.H., E.J.B., V.G. and S. Kääb. Study supervision was performed by P.T.E., K.L.L., C.M.A., M.K.C., N.L.S., J.I.R., A.H., P.M.R., B.M.P., J.C.M.W., A.G.U., Y.L., B.H.C.S., S.B.F., S.R.H., E.J.B., V.G. and S. Kääb., P.T.E., K.L.L., C.M.A., N.L.G., M.D.R., A.V.S., D.E.A., M.M.-N., B.P.K., J.C.B., M.K.C., M.D., K.O., T. Tanaka, B.H.C.S., S.B.F., A.A., D.D., J.B., D.I.C., S.R.H., V.G., E.J.B. and S. Kääb had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

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Correspondence to Patrick T Ellinor or Stefan Kääb.

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The authors declare no competing financial interests.

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Supplementary Tables 1–5, Supplementary Figures 1–3 and Supplementary Note (PDF 803 kb)

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Ellinor, P., Lunetta, K., Albert, C. et al. Meta-analysis identifies six new susceptibility loci for atrial fibrillation. Nat Genet 44, 670–675 (2012). https://doi.org/10.1038/ng.2261

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