Evidence map›Paper›PMID 24755784›Full record

Observational studyAnesthesiology2014

GNAS gene variants affect β-blocker-related survival after coronary artery bypass grafting.

Ulrich H Frey, Jochen D Muehlschlegel, Christoph Ochterbeck, Amanda A Fox, Stanton K Shernan, Charles D Collard, Peter Lichtner, Jürgen Peters, Simon Body

Open access · bronzeAbstract readMulticenter StudyObservational Study
In one paragraph

Observational study in Anesthesiology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.6field-weighted citation impact, top 34% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 9 citations in OpenAlex.

  1. Article
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  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 3 institutions in 2 countries.

Ulrich H Frey *Klinik für Anästhesiologie und Intensivmedizin, Universität Duisburg-Essen and Universitätsklinikum Essen, Essen, Germany (U.H.F., C.O., J.P.); Department of Anesthesiology, Perioperative, and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts (J.D.M., S.K.S., S.B.); Department of Anesthesiology and Pain Management, Southwestern Medical Center, Dallas, Texas (A.A.F.); Division of Cardiovascular Anesthesiology, Texas Heart Institute, St. Luke's Episcopal Hospital, Houston Texas (C.D.C.); and Helmholtz Zentrum München, Deutsches Forschungszentrum für Gesundheit und Umwelt, Neuherberg, Germany (P.L.).
Jochen D Muehlschlegel *Klinik für Anästhesiologie und Intensivmedizin, Universität Duisburg-Essen and Universitätsklinikum Essen, Essen, Germany (U.H.F., C.O., J.P.); Department of Anesthesiology, Perioperative, and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts (J.D.M., S.K.S., S.B.); Department of Anesthesiology and Pain Management, Southwestern Medical Center, Dallas, Texas (A.A.F.); Division of Cardiovascular Anesthesiology, Texas Heart Institute, St. Luke's Episcopal Hospital, Houston Texas (C.D.C.); and Helmholtz Zentrum München, Deutsches Forschungszentrum für Gesundheit und Umwelt, Neuherberg, Germany (P.L.).
Christoph OchterbeckKlinik für Anästhesiologie und Intensivmedizin, Universität Duisburg-Essen and Universitätsklinikum Essen, Essen, Germany (U.H.F., C.O., J.P.); Department of Anesthesiology, Perioperative, and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts (J.D.M., S.K.S., S.B.); Department of Anesthesiology and Pain Management, Southwestern Medical Center, Dallas, Texas (A.A.F.); Division of Cardiovascular Anesthesiology, Texas Heart Institute, St. Luke's Episcopal Hospital, Houston Texas (C.D.C.); and Helmholtz Zentrum München, Deutsches Forschungszentrum für Gesundheit und Umwelt, Neuherberg, Germany (P.L.).
Amanda A FoxKlinik für Anästhesiologie und Intensivmedizin, Universität Duisburg-Essen and Universitätsklinikum Essen, Essen, Germany (U.H.F., C.O., J.P.); Department of Anesthesiology, Perioperative, and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts (J.D.M., S.K.S., S.B.); Department of Anesthesiology and Pain Management, Southwestern Medical Center, Dallas, Texas (A.A.F.); Division of Cardiovascular Anesthesiology, Texas Heart Institute, St. Luke's Episcopal Hospital, Houston Texas (C.D.C.); and Helmholtz Zentrum München, Deutsches Forschungszentrum für Gesundheit und Umwelt, Neuherberg, Germany (P.L.).
Stanton K ShernanKlinik für Anästhesiologie und Intensivmedizin, Universität Duisburg-Essen and Universitätsklinikum Essen, Essen, Germany (U.H.F., C.O., J.P.); Department of Anesthesiology, Perioperative, and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts (J.D.M., S.K.S., S.B.); Department of Anesthesiology and Pain Management, Southwestern Medical Center, Dallas, Texas (A.A.F.); Division of Cardiovascular Anesthesiology, Texas Heart Institute, St. Luke's Episcopal Hospital, Houston Texas (C.D.C.); and Helmholtz Zentrum München, Deutsches Forschungszentrum für Gesundheit und Umwelt, Neuherberg, Germany (P.L.).
Charles D CollardKlinik für Anästhesiologie und Intensivmedizin, Universität Duisburg-Essen and Universitätsklinikum Essen, Essen, Germany (U.H.F., C.O., J.P.); Department of Anesthesiology, Perioperative, and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts (J.D.M., S.K.S., S.B.); Department of Anesthesiology and Pain Management, Southwestern Medical Center, Dallas, Texas (A.A.F.); Division of Cardiovascular Anesthesiology, Texas Heart Institute, St. Luke's Episcopal Hospital, Houston Texas (C.D.C.); and Helmholtz Zentrum München, Deutsches Forschungszentrum für Gesundheit und Umwelt, Neuherberg, Germany (P.L.).
Peter LichtnerKlinik für Anästhesiologie und Intensivmedizin, Universität Duisburg-Essen and Universitätsklinikum Essen, Essen, Germany (U.H.F., C.O., J.P.); Department of Anesthesiology, Perioperative, and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts (J.D.M., S.K.S., S.B.); Department of Anesthesiology and Pain Management, Southwestern Medical Center, Dallas, Texas (A.A.F.); Division of Cardiovascular Anesthesiology, Texas Heart Institute, St. Luke's Episcopal Hospital, Houston Texas (C.D.C.); and Helmholtz Zentrum München, Deutsches Forschungszentrum für Gesundheit und Umwelt, Neuherberg, Germany (P.L.).
Jürgen Peters *Klinik für Anästhesiologie und Intensivmedizin, Universität Duisburg-Essen and Universitätsklinikum Essen, Essen, Germany (U.H.F., C.O., J.P.); Department of Anesthesiology, Perioperative, and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts (J.D.M., S.K.S., S.B.); Department of Anesthesiology and Pain Management, Southwestern Medical Center, Dallas, Texas (A.A.F.); Division of Cardiovascular Anesthesiology, Texas Heart Institute, St. Luke's Episcopal Hospital, Houston Texas (C.D.C.); and Helmholtz Zentrum München, Deutsches Forschungszentrum für Gesundheit und Umwelt, Neuherberg, Germany (P.L.).
Simon Body *Klinik für Anästhesiologie und Intensivmedizin, Universität Duisburg-Essen and Universitätsklinikum Essen, Essen, Germany (U.H.F., C.O., J.P.); Department of Anesthesiology, Perioperative, and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts (J.D.M., S.K.S., S.B.); Department of Anesthesiology and Pain Management, Southwestern Medical Center, Dallas, Texas (A.A.F.); Division of Cardiovascular Anesthesiology, Texas Heart Institute, St. Luke's Episcopal Hospital, Houston Texas (C.D.C.); and Helmholtz Zentrum München, Deutsches Forschungszentrum für Gesundheit und Umwelt, Neuherberg, Germany (P.L.).
Essen University Hospital · DESouthwestern Medical CenterBrigham and Women's Hospital · US

Funding

Genetics of gene expression in human left ventricular myocardiumR01HL118266 · NHLBI · BRIGHAM AND WOMEN'S HOSPITAL · PI MUEHLSCHLEGEL, JOCHEN DANIEL · 2013 to 2017
$2.3M
Identification of Genetic and Molecular Mechanisms of Atrial FibrillationR01HL098601 · NHLBI · BRIGHAM AND WOMEN'S HOSPITAL · PI BODY, SIMON C · 2010 to 2014
$2.2M
Genotypic Impact on Outcomes after CABG SurgeryK23HL068774 · NHLBI · BRIGHAM AND WOMEN'S HOSPITAL · PI BODY, SIMON C · 2002 to 2006
$803k
NHLBI NIH HHS K23 HL068774NHLBI NIH HHS R01 HL098601NHLBI NIH HHS R01 HL118266
6 · The paper itself

Abstract

backgroundCardiac overexpression of the β-adrenoreceptor (βAR)-coupled stimulatory G-protein subunit Gαs enhances inotropic responses to adrenergic stimulation and improves survival in mice under βAR blockade. The authors recently identified three common haplotypes in the GNAS gene encoding Gαs, with the greatest Gαs protein expression and signal transduction in haplotype *3 carriers and less in haplotype *2 and *1 carriers. The authors tested the hypothesis that these GNAS variants result in altered mortality in patients after coronary artery bypass graft surgery, particularly in those receiving βAR blockade.

methodsThis prospective analysis included 1,627 European ancestry patients undergoing primary coronary artery bypass graft surgery. Patients were genotyped for two GNAS haplotype tagging single-nucleotide polymorphisms defining three major haplotypes. Up to 5-yr all-cause mortality was estimated using a Cox proportional hazard model; hazard ratios and 95% CIs were calculated while adjusting for demographics, clinical covariates, and the new EuroSCORE II.

resultsUnivariate analysis revealed haplotype-dependent 5-yr mortality rates (*1/*1: 18.9%, *2/*1: 13.7%, *2/*2: 9.3%, *3/*1: 10.6%, *3/*2: 9.1%, and *3/*3: 9.6%; P = 0.0006). After adjustment for other predictors of death, homozygote haplotype *1 carriers showed a doubled risk for death (hazard ratio, 2.2; 95% CI, 1.2 to 3.8; P = 0.006). Considering only patients receiving βAR blockers (n = 1,267), the adjusted risk of death even tripled (hazard ratio, 3.0; 95% CI, 1.5 to 6.1; P = 0.002).

conclusionsGNAS haplotypes independently associate with an increased risk of death after primary coronary artery bypass graft surgery. These results are most pronounced in patients receiving βAR blockers, strengthening the rationale for personalized treatment, to decrease medication side effects and improve outcomes.

Indexed as

Adrenergic beta-AntagonistsAdultAgedAged, 80 and overChromograninsCohort StudiesCoronary Artery BypassFemaleGenetic VariationGTP-Binding Protein alpha Subunits, GsHaplotypesHumansLongitudinal StudiesMaleMiddle AgedPolymorphism, Single NucleotideAdrenergic beta-AntagonistsChromograninsGNAS protein, humanGTP-Binding Protein alpha Subunits, Gs

Identifiers

PMID24755784
PMCPMC4070180
OpenAlexW2009815161

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Read underepoch 390

Registered trials

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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.