A common variant of the AMPD1 gene predicts improved survival in patients with ischemic left ventricular dysfunction.
BACKGROUND
A recent retrospective study suggested that the adenosine monophosphate deaminase (AMPD)-1 gene variant C34T predicts outcome in heart failure patients. This variant might lead to ischemic preconditioning by increasing tissue adenosine. We tested whether the survival benefit of C34T occurs preferentially in the setting of ischemic left ventricular dysfunction.


RESULTS
A consecutive cohort of patients (n=390) with left ventricular ejection fraction <40% was evaluated. In the ischemic patient subgroup (n=210) multivariate analysis identified AMPD1 T allele carriage (hazard ratio=0.43, confidence interval=0.20-0.94, P=.035) as an independent predictor of transplant-free cardiovascular survival. No benefit was found in the nonischemic group although the number of events was too small to reliably exclude a benefit by genotype.


CONCLUSIONS
The AMPD1 C34T polymorphism influences transplant-free cardiovascular survival in the setting of ischemic left ventricular dysfunction.
Cardiovascular Department, LDS Hospital, Salt Lake City, Utah 84143, USA.
Yoshikazu
Y
Yazaki
Joseph B
JB
Muhlestein
John F
JF
Carlquist
Tami L
TL
Bair
Benjamin D
BD
Horne
Dale G
DG
Renlund
Jeffrey L
JL
Anderson
D000659:AMP Deaminase / Q000235:genetics*; D000328:Adult; D000368:Aged; D000483:Alleles; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D005787:Gene Frequency / Q000235:genetics; D020022:Genetic Predisposition to Disease / Q000453:epidemiology / Q000235:genetics; D005838:Genotype; D016027:Heart Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D017202:Myocardial Ischemia / Q000235:genetics* / Q000401:mortality* / Q000601:surgery; D011237:Predictive Value of Tests; D013318:Stroke Volume / Q000235:genetics; D013997:Time Factors; D018487:Ventricular Dysfunction, Left / Q000235:genetics* / Q000401:mortality* / Q000601:surgery
D000659:AMP Deaminase