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Angiotensin system polymorphisms and traditional risk factors as predictors of heart failure prognosis
Author(s) -
Hudson A. A.,
Zineh I.,
Yarandi H. N.,
Langaee T. Y.,
Pauly D. F.,
Johnson J. A.
Publication year - 2005
Publication title -
clinical pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.941
H-Index - 188
eISSN - 1532-6535
pISSN - 0009-9236
DOI - 10.1016/j.clpt.2004.12.130
Subject(s) - medicine , heart failure , odds ratio , population , angiotensin ii , diabetes mellitus , angiotensin receptor , endocrinology , cardiology , blood pressure , environmental health
Background Traditional risk factors affect heart failure (HF) severity and outcomes. We investigated whether angiotensin system gene polymorphisms would offer additional prognostic information when considered with traditional risk factors. Methods Patients with chronic HF were enrolled and followed for first event (all‐cause mortality, heart transplant, or HF hospitalization). Logistic regression was used to examine the effects of covariates on outcome. Variables included risk factors previously shown to affect prognosis in our population as well as polymorphisms in the ACE (ACE I/D), angiotensinogen (AGT 235T/C), and angiotensin type 1 receptor (AGTR1 1166A/C) genes determined by pyrosequencing or dHPLC. β‐blocker, ACE inhibitor, and diuretic use was near unity at baseline and end of follow‐up and not included in the model. Significance for inclusion in the model was set at 0.1. Results Patients (n=237) were followed for a median of 18 months (6 months min, 36 months max). Significant markers of HF prognosis are presented (see Table). Polymorphisms in three genes of the angiotensin system were not associated with outcomes, nor were age, race, sex, diabetes, dyslipidemia, or serum creatinine. Conclusion Angiotensin system genes were not associated with HF prognosis in this population. The high use of ACE inhibitors and β‐blockers in this population may have ameliorated genetic influence on prognosis. Clinical Pharmacology & Therapeutics (2005) 77 , P63–P63; doi: 10.1016/j.clpt.2004.12.130Variable Odds Ratio 90 CI P‐valueSerum sodium 0.86 0.78–0.93 0.003 NYHA class 1.84 1.31–2.60 0.003 Previous CABG 1.85 1.03–3.30 0.08