GSBS Student Publications

Title

Polymorphism in KIF6 gene and benefit from statins after acute coronary syndromes: results from the PROVE IT-TIMI 22 study

UMMS Affiliation

Celera

Date

1-29-2008

Document Type

Article

Medical Subject Headings

Cohort Studies; Coronary Disease; Dose-Response Relationship, Drug; Double-Blind Method; Female; Heptanoic Acids; Heterozygote; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Kinesin; Male; Middle Aged; *Polymorphism, Genetic; Pravastatin; Pyrroles; Risk Factors; Treatment Outcome

Disciplines

Life Sciences | Medicine and Health Sciences

Abstract

OBJECTIVES: We explored whether the benefit of intensive versus moderate statin therapy would be greater in carriers of KIF6 719Arg than in noncarriers.

BACKGROUND: The 719Arg variant of Trp719Arg (rs20455), a polymorphism in kinesin-like protein 6, is associated with greater risk of coronary events and greater benefit from pravastatin versus placebo.

METHODS: We genotyped 1,778 acute coronary syndrome patients within the PROVE IT-TIMI 22 (Pravastatin or Atorvastatin Evaluation and Infection Therapy: Thrombolysis in Myocardial Infarction 22) trial and investigated different intensities of statin therapy in carriers of 719Arg and in noncarriers using Cox proportional hazards models that adjusted for traditional risk factors.

RESULTS: Benefit from intensive, compared with moderate, statin therapy was significantly greater in the 59% of the cohort who were carriers (hazard ratio [HR] 0.59, 95% confidence interval [CI] 0.45 to 0.77) than in those who were noncarriers (HR 0.94, 95% CI 0.70 to 1.27; p = 0.018 for interaction between 719Arg carrier status and treatment). Absolute risk reduction was 10.0% in carriers versus 0.8% in noncarriers. The benefit of intensive therapy in carriers was significant as early as day 30 of therapy. Carriers and noncarriers did not differ in on-treatment low-density lipoprotein cholesterol, triglyceride, or C-reactive protein (CRP) levels.

CONCLUSIONS: Carriers of 719Arg receive significantly greater benefit from intensive statin therapy than do noncarriers, a superior benefit that appears to be due to a mechanism distinct from lipid or CRP lowering. Functional studies of the KIF6 kinesin are warranted, given the consistent association of Trp719Arg with risk of coronary events and statin benefit.

Rights and Permissions

Citation: J Am Coll Cardiol. 2008 Jan 29;51(4):449-55. Link to article on publisher's site

DOI of Published Version

10.1016/j.jacc.2007.10.017

Related Resources

Link to Article in PubMed

Journal Title

Journal of the American College of Cardiology

PubMed ID

18222355