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D-PO01-142 - Predictive Association Of Single Nucleotide Polymorphisms With Cardioembolic Stroke In Patients With Atrial Fibrillation (ID 1506)


Background: Cardioembolic stroke is a known complication of atrial fibrillation (AF).
Objective: We evaluated association of single nucleotide polymorphisms (SNPs) with stroke in AF patients.
Methods: A total of 1,485 consecutive patients undergoing AF ablation were prospectively enrolled in the DECAF II study. DNA was extracted from blood samples using TaqMan assay. The samples were genotyped for 22 AF-related SNPs, identified from literature and the DECAF I trial (NCT01751607). Three genetic models (dominant, recessive, additive) were employed to evaluate association with stroke. Multivariate logistic regression analysis was used for assessing predictive role of SNPs and kernel-machine approach was applied to test global multi-marker association across the SNPs.
Results: Of the 1485 patients, 76 had history of stroke reported after AF diagnosis, prior to the ablation procedure. Of the 22 SNPs genotyped, rs10033464, rs17570669, rs16997168 and rs1448817 showed significant combined association with stroke in recessive model; SNPs rs16997168 and rs1448817 were significant in additive and recessive model (table). While rs10033464, rs17570669 and rs16997168 predicted a higher stroke risk, rs1448817 conferred 81% reduction in odds for stroke. This protective effect was demonstrated despite comparable baseline CHA2DS2-VASc score among patients with and without rs1448817 risk allele (2.11±1.22 and 2.28±1.43, p 0.12).
Conclusion: Our results identified predictive association of four genetic variants located on chromosome 4q25 with stroke in AF patients. The SNP, rs1448817 was found to have a protective effect against stroke whereas the other 3 SNPs increased stroke risk.