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April 11, 2026Bulletin of the National Research Centre/Bulletin of the National Research Center0 citationsOpen Access

Genetic analysis of symptomatic premature coronary artery disease in an ethnolinguistic Southeast Asian group: a pilot case-control study

KPKushal PujaraKYKrushan YajnikBVBhalendu S. Vaishnav

Key Result

Genome-wide association analysis identified three novel loci in the BACH2, PRKG2, and KCNIP4 genes that were significantly associated with premature coronary artery disease in a Gujarati population.

Key Points

  • The study aims to analyze genetic factors associated with symptomatic premature coronary artery disease in the Gujarati ethnolinguistic group.
  • Conducted a case-control design over 15 months with 22 PCAD cases and 192 controls.
  • Performed genotyping and quality control on collected samples.
  • Utilized additive model-derived association analysis and logistic regression for statistical assessment.
  • Identified 80 SNPs after genotyping, with 16 showing strong significance after Bonferroni correction.
  • Three significant genes—BACH2, PRKG2, and KCNIP4—were consistently identified across analyses.
  • The identified genes link to critical cardiovascular functions, indicating their relevance to PCAD.

Study Design

Type

Case-Control (n=214)

Multicenter

No

Structured PICO

Are specific genetic loci (SNPs) associated with symptomatic premature coronary artery disease in an ethnolinguistic Gujarati population?

P
Population
214 individuals from an ethnolinguistic Gujarati group (Southeast Asian Population), including 22 cases of angiographically proven, symptomatic premature coronary artery disease (PCAD) without conventional risk factors, and 192 controls.
I
Intervention
Genotyping and genetic association analysis
C
Comparator
192 controls without premature coronary artery disease
O
Outcome
Identification of statistically significant single nucleotide polymorphisms (SNPs) and associated genes linked to premature coronary artery diseasesurrogate

The identification of BACH2, PRKG2, and KCNIP4 as genetic loci associated with premature CAD in a Gujarati population provides potential targets for population-specific polygenic risk scores.

Main Result

Effect estimate: OR 1021 (95% CI 50.49-16940)

p-value: p=3.348e-06

Limitations

  • Significantly small sample size limits generalisability
  • Marked sex-based disparity amongst the cases and controls
  • Ethnolinguistic subgroup-based study in an inherently high-risk population which may or may not be extrapolated
  • underpowered
  • pilot study
  • single-centre

Abstract

Non-communicable diseases, primarily Coronary Artery Diseases (CAD), are on the rise globally, with an increased ethnic predisposition towards Southeast Asian Population (SEAP) causing Premature CAD (PCAD). The current study aimed at genetic analysis of angiographically proven, symptomatic PCAD in an ethnolinguistic Gujarati group. This single-centre, cross-sectional, case control study was an underpowered, pilot study over 15 months, involving 22 cases of PCAD (without conventional risk factors) and 192 controls. After genotyping and quality control, additive model derived case control association analysis, Bonferroni correction (threshold p < 1.23E-07) and logistic regression analysis (using age, sex and Principal Components as covariates) were performed for analysis. Additive model derived 80 SNPs, further corrected by Bonferroni correction, showed 16 SNPs with strong statistical significance, which were further annotated to the genes. Three genes were consistently identified across all three models of analysis: BACH2, PRKG2 and KCNIP4, which were not only statistically significant (p < 5e-08), but also mapped to functional genomic regions, indicating a potentially clinical significance in the pathophysiology of PCAD in this population. BACH2 is seen to be associated with eosinophilia and coronary calcifications, PRKG2 with HCN and cardiac myocyte resting membrane potentials and KCNIP4 with hypertrophy and heart failure. This study provides new loci which may advance the knowledge of genetic predisposition to PCAD in the Gujarati SEAP. Larger multicentric study mediated confirmation and further incorporation into SEAP specific Polygenic Risk Score could predict PCAD in this population.

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Cite This Study

Pujara et al. (2026) conducted a case-control in Premature Coronary Artery Disease (n=214). Genotype (BACH2 rs2474881) vs. Controls was evaluated on Association with premature coronary artery disease (OR 1021, 95% CI 50.49-16940, p=3.348e-06). Genome-wide association analysis identified three novel loci in the BACH2, PRKG2, and KCNIP4 genes that were significantly associated with premature coronary artery disease in a Gujarati population.

synapsesocial.com/papers/69d9e67a78050d08c1b76ddahttps://doi.org/10.1186/s42269-026-01387-x
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