Cardiovascular Diseases Clinical Trial
To identify the genetic (major genes) and environmental factors responsible for the significant aggregation of abdominal aortic aneurysm (AAA) among relatives of affected individuals.
BACKGROUND:
Abdominal aortic aneurysm (AAA) is a dilatation of the abdominal aorta which can, if
undetected, lead to rupture. The mortality associated with ruptured AAA is estimated to be
90 percent, while elective repair has a mortality risk of approximately 6 percent. Ruptured
AAA is a leading cause of death among older Americans. The identification of markers of AAA
risk could lead to preventive intervention. AAA aggregates in families, and segregation
analysis shows that familial risk of AAA is best explained by the segregation of a major
gene with an autosomal recessive mode of inheritance.
DESIGN NARRATIVE:
Affected relative pairs (primarily sibling pairs) with AAA and no evidence of a family
history of a connective tissue disorder were genotyped for 150 highly informative
microsatellite polymorphisms marking the autosomal genome at a resolution of 20 cM. The
linkage between AAA and these loci was tested using robust affected pedigree member methods
to identify genomic regions which might contain genes that predisposed individuals to
develop AAA. The existence of predisposing gene(s) were confirmed and their location refined
using a defined search strategy, genotyping at increasing levels of resolution, and
re-analysis of family data. The predisposing gene(s) were identified by a combination of
saturation mapping and molecular analysis of candidate loci. The association of AAA with
environmental measures was investigated to determine an equation for estimating risk for
relatives of AAA patients based upon environmental measures and genotype. Power calculations
based upon the number and structure of families already collected demonstrated the
feasibility of identifying genes that predisposed to AAA using this strategy, even in the
presence of significant heterogeneity with respect to the loci involved. In addition to
identifying genes that were necessary for AAA by linkage analysis, a series of analyses of
association were undertaken to identify true susceptibility genes that were neither
necessary nor sufficient to cause disease, but which modified an individual's risk of
developing AAA.
The study completion date listed in this record was obtained from the "End Date" entered in
the Protocol Registration and Results System (PRS) record.
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