Although thoracic aortic aneurysms and dissections (TAAD) can be inherited as a single-gene disorder, the genetic predisposition in the majority of affected people is poorly understood. In a multistage genome-wide association study (GWAS), we compared 765 individuals who had sporadic TAAD (STAAD) with 874 controls and identified common SNPs at a 15q21.1 locus that were associated with STAAD, with odds ratios of 1.6–1.8 that achieved genome-wide significance. We followed up 107 SNPs associated with STAAD with P < 1 × 10−5 in the region, in two separate STAAD cohorts. The associated SNPs fall into a large region of linkage disequilibrium encompassing FBN1, which encodes fibrillin-1. FBN1 mutations cause Marfan syndrome, whose major cardiovascular complication is TAAD. This study shows that common genetic variants at 15q21.1 that probably act via FBN1 are associated with STAAD, suggesting a common pathogenesis of aortic disease in Marfan syndrome and STAAD.
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This work was supported by grants from the US National Institutes of Health (P50-HL083794 and R01-HL62594 to D.M.M.; UL1RR024148 and UL1RR025758 (CTSA); K08-HL080085 to S.A.L.), as well as the Doris Duke Charitable Trust, the Vivian L. Smith Foundation, the TexGen Foundation and the Thoracic Surgery Foundation for Research and Education.
GenTAC participating centers and their investigators are as follows: Johns Hopkins University School of Medicine, K.W.H., H.C. Dietz, W. Ravekes, K. Lurman; University of Texas Health Science Center at Houston, D.M.M., A. Carlson; Baylor College of Medicine, S.A.L., J.L. Jefferies, I.V. Volguina; Oregon Health & Science University, C.M., H.K. Song, V. Menashe, M. Silberbach, J.D. Kushner; Perelman School of Medicine at the University of Pennsylvania, R.E.P., J.E.B., M. Morales; Weill Cornell Medical College, C.T. Basson, R.D., J.W. Weinsaft, D. McDermott; University of Michigan Medical School, K.E.; US National Heart, Lung, and Blood Institute, H.E. Tolunay, P. Desvigne-Nickens, M.P. Stylianou, M. Mitchell; RTI International, B.L. Kroner, D. Brambilla, T. Hendershot, D. Ringer, M. Cunningham, M. Kindem. The GenTAC registry is supported by US Federal Government Contract N01-HV-68199 from the National Heart, Lung, and Blood Institute and by the National Institute of Arthritis and Musculoskeletal and Skin Diseases.
We thank the GenTAC investigators, collaborators and coordinators; NINDS and WTCCC for giving us the use of their control data; S.N. Palmer, N. Stancel and R. Bartow for editorial assistance; Y. Khalil for subject recruitment; Z. Ren for technical support; A. Kicza for her dedicated work contacting and talking to subjects; and all of the subjects who participated in this research. We thank the surgeons of Brigham and Women's Hospital: S.F. Aranki, R.M. Bolman III, F.Y. Chen, L.H. Cohn, G.S. Couper, M. Davidson, R.J. Rizzo and P. Shekar. We also thank the surgeons of Massachusetts General Hospital: A. Agnihotri, C. Akins, A.D. Hilgenberg, T.E. MacGillivray, J.C. Madsen, B.R. Rosengard, D.F. Torchiana, G.J. Vlahakes and J.D. Walker.
Supplementary Figures 1 and 2; Supplementary Tables 1-11
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Journal of Human Hypertension (2019)