Genetic risk factors for postoperative atrial fibrillation-a nationwide genome-wide association study (GWAS)

Mathias A Christensen; Alexander Bonde; Martin Sillesen

doi:10.3389/fcvm.2023.1040757

Genetic risk factors for postoperative atrial fibrillation-a nationwide genome-wide association study (GWAS)

Front Cardiovasc Med. 2023 Jun 19:10:1040757. doi: 10.3389/fcvm.2023.1040757. eCollection 2023.

Authors

Mathias A Christensen^{1

2}, Alexander Bonde^{1

2}, Martin Sillesen^{1

2

3}

Affiliations

¹ Department of Surgery and Transplantation, Copenhagen University Hospital, Rigshosptialet, Denmark.
² Center for Surgical Translational and Artificial Intelligence Research (CSTAR), Copenhagen University Hospital, Rigshospitalet, Denmark.
³ Institute of Clinical Medicine, University of Copenhagen Medical School, Copenhagen, Denmark.

Abstract

Background: Atrial fibrillation (AF) is a major cause of morbidity with a high prevalence among the elderly and has an established genetic disposition. Surgery is a well-known risk factor for AF; however, it is currently not recognized how much common genetic variants influence the postoperative risk. The purpose of this study was to identify Single Nucleotide Polymorphisms associated with postoperative AF.

Methods: The UK Biobank was utilized to conduct a Genome-Wide Association Study (GWAS) to identify variants associated with AF after surgery. An initial discovery GWAS was performed in patients that had undergone surgery with subsequent replication in a unique non-surgical cohort. In the surgical cohort, cases were defined as newly diagnosed AF within 30 days after surgery. The threshold for significance was set at 5 × 10^-8.

Results: After quality control, 144,196 surgical patients with 254,068 SNPs were left for analysis. Two variants (rs17042171 (p = 4.86 × 10^-15) and rs17042081 (p = 7.12 × 10^-15)) near the PITX2-gene reached statistical significance. These variants were replicated in the non-surgical cohort (1.39 × 10^-101 and 1.27 × 10^-93, respectively). Several other loci were significantly associated with AF in the non-surgical cohort.

Conclusion: In this GWAS-analysis of a large national biobank, we identified 2 variants that were significantly associated with postoperative AF. These variants were subsequently replicated in a unique non-surgical cohort. These findings bring new insight in the genetics of postoperative AF and may help identify at-risk patients and guide management.

Keywords: GWAS; PITX2; SNP; atrial fibrillation; personalized medicine; postoperative.

Grants and funding

Funded by a grant from the Novo Nordisk Foundation to MS (Grant #NNF20SA0062879).