Within the chr9p21.3 locus, the single-nucleotide polymorphism rs1333049 has been demonstrated to be most strongly associated with susceptibility to developing coronary artery disease. However, the effect of rs1333049 on clinical outcomes in patients with established coronary disease has yet to be determined.
Methods and Results-Coronary Disease Cohort Study (CDCS) (n=1054) and
Post-Myocardial Infarction (PMI) (n=816) study participants were genotyped for rs1333049. Clinical history, circulating lipids, neurohormones, cardiac function, and discharge medications click here were documented. All-cause mortality and cardiovascular hospital readmissions were recorded over a median follow-up period of 4.0 years for the CDCS cohort and 9.1 years for the PMI cohort. The CDCS patients homozygous for the high-risk C allele had an age of onset 2 to 5 years earlier for coronary disease (P=.005), angina (P=.025), myocardial infarction (P=.022), and percutaneous transluminal coronary angioplasty (P=.009). Patients with the CC genotype also had higher levels of total cholesterol (P=.033) and triglycerides (P=.003). The PMI participants with the CC genotype were 3 years younger on admission (P=.009). Cox proportional hazards analysis adjusting for established
predictors of increased risk showed no significant association between rs1333049 genotype and mortality in either the CDCS (P=.214) or the learn more PMI (P=.696) cohorts.
Conclusions-The chr9p21.3 polymorphism rs1333049 was associated with an earlier age of disease onset in 2 coronary disease cohorts but not with poorer clinical outcome in either cohort. (Circ Cardiovasc Genet. 2010; 3: 286-293.)”
“Purpose of review
Psychosocial outcomes and quality-of-life (QOL) are important indicators of the success of heart transplantation and mechanical circulatory support (MCS). They warrant further research attention given the increasing frequency of these interventions and the diverse uses of MCS as destination therapy and bridge
to transplant.
Recent findings
The literature has continued to identify correlates and predictors of psychosocial outcomes in five domains: physical functioning, psychological, behavioral, social functioning and global QOL. These issues in MCS patients, in particular, are receiving increased www.selleckchem.com/products/blz945.html attention. Recent work also highlights the potential for psychosocial outcomes to predict transplant-related and MCS-related clinical outcomes, and also emphasizes issues involved in heart transplantation for older adults, heart transplantation for intellectually disabled individuals, and managing end-of-life planning in patients with MCS.
Summary
This field continues to be dominated by descriptive studies. Although recent work has provided a more complete picture of correlates of psychosocial outcomes, there is a need for intervention research to examine strategies to optimize these outcomes in both heart transplant and MCS populations.