Genetic Variants Associated with Supernormal Coronary Arteries

Aims: Genetic and medical insights from studies on cardioprotective phenotypes aid the development of novel therapeutics. This study identified genetic variants associated with supernormal coronary arteries using genome-wide association study data and the corresponding genes based on expression quantitative trait loci (eQTL). Methods: Study participants were selected from two Korean cohorts according to inclusion criteria that included males with high cardiovascular risk (Framingham risk score ≥ 14, 10-year risk ≥ 16%) but with normal coronary arteries (supernormal group) or coronary artery disease (control group). After screening 12,309 individuals, males meeting the supernormal phenotype (n=72) and age-matched controls (n=94) were enrolled. Genetic variants associated with the supernormal phenotype were identified using Firth’s logistic regression, and eQTL was used to evaluate whether the identified variants influence the expression of particular genes in human tissues. Results: Approximately 5 million autosomal variants were tested for association with the supernormal phenotype, and 10 independent loci suggestive of supernormal coronary arteries (p＜5.0×10(−5)) were identified. The lead variants were seven intergenic single-nucleotide polymorphisms (SNPs), including one nearPBX1, and three intronic SNPs, including one inPPFIA4. Of these variants or their proxies, rs9630089, rs6427989, and rs4984694 were associated with expression levels ofSLIT1 andARHGAP19,PPFIA4, andMETTL26 in human tissues, respectively. These eQTL results supported their potential biological relevance. Conclusions: This study identified genetic variants and eQTL genes associated with supernormal coronary arteries. These results suggest candidate genes representing potential therapeutic targets for coronary artery disease.