ArticleJournal of the American College of Cardiology2012
Adrenergic-pathway gene variants influence beta-blocker-related outcomes after acute coronary syndrome in a race-specific manner.
Article in Journal of the American College of Cardiology, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it, 40 citations in OpenAlex.
- βGenetic testing and molecular biomarkers · 2019Pooled it
- Effect of Beta-Blocker Dose on Survival After Acute Myocardial Infarction.Journal of the American College of Cardiology · 2015Trial
- Association between adrenergic receptor genotypes and beta-blocker dose in heart failure patients: analysis from the HF-ACTION DNA substudy.European journal of heart failure · 2013Trial
- Prognostic relevance of β1-adrenergic receptor polymorphisms on cardiovascular outcome in patients treated with metoprolol after acute myocardial infarction - an observational study.European journal of clinical pharmacology · 2026Observational
- The Impact of Gender and Race When Using the GRACE ACS Score to Predict Mortality.HCA healthcare journal of medicine · 2023Article
- Associations betweenCardiology research and practice · 2022Article
- Polygenic Score for β-Blocker Survival Benefit in European Ancestry Patients With Reduced Ejection Fraction Heart Failure.Circulation. Heart failure · 2020Article
- Association between the EPHX2 p.Lys55Arg polymorphism and prognosis following an acute coronary syndrome.Prostaglandins & other lipid mediators · 2018Article
- A novel genetic marker of decreased inflammation and improved survival after acute myocardial infarction.Basic research in cardiology · 2018Observational
- Race and Beta-Blocker Survival Benefit in Patients With Heart Failure: An Investigation of Self-Reported Race and Proportion of African Genetic Ancestry.Journal of the American Heart Association · 2018Observational
- Perioperative Inotrope Therapy and Atrial Fibrillation Following Coronary Artery Bypass Graft Surgery: Evidence of a Racial Disparity.Pharmacotherapy · 2017Article
- Practical Pharmacogenomic Approaches to Heart Failure Therapeutics.Current treatment options in cardiovascular medicine · 2016Review
- The evolving impact of g protein-coupled receptor kinases in cardiac health and disease.Physiological reviews · 2015Review
- CHRNA5 variant predicts smoking cessation in patients with acute myocardial infarction.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2014Article
- Cytochrome p450 gene variants, race, and mortality among clopidogrel-treated patients after acute myocardial infarction.Circulation. Cardiovascular genetics · 2014Observational
- GNAS gene variants affect β-blocker-related survival after coronary artery bypass grafting.Anesthesiology · 2014Observational
- Discharge β-Blocker Use and Race after Coronary Artery Bypass Grafting.Frontiers in public health · 2014Article
- Adrenergic nervous system in heart failure: pathophysiology and therapy.Circulation research · 2013Review
- Highlights of the year in JACC 2012.Journal of the American College of Cardiology · 2013Review
- Pharmacogenomics in heart failure: where are we now and how can we reach clinical application?Cardiology in reviewReview
Corrections and comments
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Authors and funding
9 authors at 4 institutions in 1 country.
Funding
Abstract
objectivesOvercoming racial differences in acute coronary syndrome (ACS) outcomes is a strategic goal for U.S. health care. Genetic polymorphisms in the adrenergic pathway seem to explain some outcome differences by race in other cardiovascular diseases treated with β-adrenergic receptor blockade (BB). Whether these genetic variants are associated with survival among ACS patients treated with BB, and if this differs by race, is unknown.
backgroundβ-adrenergic receptor blockade after ACS is a measure of quality care, but the effectiveness across racial groups is less clear.
methodsA prospective cohort of 2,673 ACS patients (2,072 Caucasian; 601 African-American) discharged on BB from 22 U.S. hospitals were followed for 2 years. Subjects were genotyped for polymorphisms in ADRB1, ADRB2, ADRA2C, and GRK5. We used proportional hazards regression to model the effect of genotype on mortality, stratified by race and adjusted for baseline factors.
resultsThe overall 2-year mortality rate was 7.5% for Caucasians and 16.7% for African Americans. The prognosis associated with different genotypes in these BB-treated patients differed by race. In Caucasians, ADRA2C 322-325 deletion carriers had significantly lower mortality as compared with homozygous individuals lacking the deletion (hazard ratio: 0.46; confidence interval [CI]: 0.21 to 0.99; p = 0.047; race × genotype interaction p = 0.053). In African Americans, the ADRB2 16R allele was associated with significantly increased mortality (hazard ratio for RG vs. GG: 2.10; CI: 1.14 to 3.86; RR vs. GG: 2.65; CI: 1.38 to 5.08; p = 0.013; race × genotype interaction p = 0.096).
conclusionsAdrenergic pathway polymorphisms are associated with mortality in ACS patients receiving BB in a race-specific manner. Understanding the mechanism by which different genes impact post-ACS mortality differently in Caucasians and African Americans might illuminate opportunities to improve BB therapy in these groups.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.