Objective-We tested the hypothesis that 6 nonsynonymous single nucleotide polymorphisms (SNPs) in ATP-BindingCassette transporter A1 (ABCA1) affect risk of ischemic heart disease (IHD) in the general population. Methods and Results-We genotyped 9259 individuals from the Danish general population followed for 25 years. Two SNPs (V771M and V825I) were previously associated with increases in HDL-C, 1 (R1587K) with decreased HDL-C, whereas 3 (R219K, I883M and E1172D) did not affect HDL-C levels. Despite this, 5 out of 6 SNPs (V771M, V825I, I883M, E1172D, R1587K) predicted increased risk of IHD. Similar results were obtained in a verification sample with 932 IHD cases versus 7999 controls. A stepwise regression approach identified V771M, I883M, and E1172D as the most important predictors of IHD and additive effects on IHD risk were present for V771M/I883M and I883M/E1172D pairs. Conclusions-We show that 3 of 6 nonsynonymous SNPs in ABCA1 predict risk of IHD in the general population.(Arterioscler Thromb Vasc Biol. 2008;28:180-186.)Key Words: atherosclerosis Ⅲ cardiovascular diseases Ⅲ genetics Ⅲ lipids Ⅲ lipoproteins I schemic heart disease (IHD) is the most common cause of death in developed countries, 1 and a low level of plasma high-density lipoprotein cholesterol (HDL-C) is a major risk factor for IHD in the general population. 2 An important atheroprotective property of the HDL particle is thought to be its key function in reverse cholesterol transport mobilizing cellular cholesterol from arterial wall macrophages to lipid poor plasma apolipoproteins, a transport that is mediated by the transmembrane ATP-BindingCassette transporter A1 (ABCA1). 3 Mutations in the ABCA1 gene cause rare mendelian HDL deficiency syndromes characterized in the homozygous form by almost complete absence of HDL particles in plasma, but only a modest if any increase in risk of IHD, and in the heterozygous form by half-normal HDL-C levels. 4 -7 Recently, we and others have shown that both rare and common variants in the ABCA1 gene also contribute to HDL-C levels in the general population. 8,9 Whether common genetic variation in ABCA1 predicts risk of IHD in the general population is currently unknown.This study was performed to test the hypothesis that 6 nonsynonymous single nucleotide polymorphisms (SNPs) in ABCA1 affect risk of IHD in the general population.
Methods
Subjects
General Population SampleThe Copenhagen City Heart Study is a prospective study of the Danish general population initiated in 1976 to 1978 with follow-up examinations in 1981 to 1983 and 1991 to 1994. 10,11 Individuals were selected based on the Central Population Register Code to reflect the adult Danish general population aged 20 to 80ϩ years. In the present study we included 9259 individuals from the 1991 to 1994 examination, whom we genotyped for all nonsynonymous SNPs (R219K, V771M, V825I, I883M, E1172D, R1587K) identified by resequencing ABCA1 in 190 individuals of Danish ancestry. 8 Information on diagnosis of IHD (nϭ1170; World Health Organization; Inte...