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Background  This study was aimed to investigate the clinical relevance between glycoprotein Ia (GPIA) rs1126643C/T polymorphism and the outcome of coronary artery disease after coronary artery bypass graft (CABG) surgery and explore the involved potential mechanisms.    Methods and Results  We genotyped GPIA rs1126643 polymorphism of 1592 patients who underwent CABG and followed up for a median period of 72.8 months. Patients who are GPIA rs1126643 T‐allele carriers have a higher major adverse cardiac or cerebrovascular events risk post‐CABG than those who are CC homozygotes (hazard ratio [HR]=1.29;  P =0.022). The clinical association between the risk allele (T) carriage and major adverse cardiac or cerebrovascular events was confirmed in another cohort study, which included 646 CABG patients from various health centers across China. Meanwhile, rs1126643 T allele was also linked with increased risk of major adverse cardiac or cerebrovascular events (HR=1.73;  P =0.019). To explore the underlying mechanisms, we prospectively recruited 131 coronary artery disease patients, assessed their platelet aggregation function, and focused on detecting their GPIA mRNA level and protein expression. Results showed that patients with rs1126643 T allele have elevated platelet aggregation activity ( P =0.029) when protein expression is increased ( P <0.001) and not affected by glycoprotein Ia mRNA level.    Conclusions  The synonymous common variant, GPIA rs1126643, increases the long‐term adverse events risk of CABG by augmenting GPIa protein expression and enhancing platelet aggregation function. This finding can serve as the implication of improving secondary prevention of CABG patients.

Common Variant in Glycoprotein Ia Increases Long‐Term Adverse Events Risk After Coronary Artery Bypass Graft Surgery