Genetic polymorphisms associated with statin response and cardiovascular diseases, methods of detection and uses thereof

Abstract

The present invention provides compositions and methods based on genetic polymorphisms that are associated with response to statin treatment, particularly for reducing the risk of cardiovascular disease, especially coronary heart disease (such as myocardial infarction) and stroke. For example, the present invention relates to nucleic acid molecules containing the polymorphisms, variant proteins encoded by these nucleic acid molecules, reagents and kits for detecting the polymorphic nucleic acid molecules and variant proteins, and methods of using the nucleic acid molecules and proteins as well as methods of using reagents and kits for their detection.

1 . A method for determining whether a human's risk for cardiovascular disease (CVD) is reduced by treatment with an HMG-CoA reductase inhibitor, the method comprising testing nucleic acid from said human for the presence or absence of an allele at a polymorphism as represented by position 101 of any one of the nucleotide sequences of SEQ ID NOS:623-3661 or its complement, wherein the presence of said allele indicates said human's risk for CVD is reduced by treatment with said HMG-CoA reductase inhibitor. 
     
     
         2 . The method of  claim 1 , further comprising correlating the presence of said allele with a reduction of said risk for CVD by an HMG-CoA reductase inhibitor. 
     
     
         3 . The method of  claim 2 , wherein said correlating is performed by computer software. 
     
     
         4 . The method of  claim 1 , wherein said HMG-CoA reductase inhibitor is a hydrophilic statin. 
     
     
         5 . The method of  claim 1 , wherein said HMG-CoA reductase inhibitor is a hydrophobic statin. 
     
     
         6 . The method of  claim 1 , wherein said HMG-CoA reductase inhibitor is selected from the group consisting of atorvastatin (Lipitor®), rosuvastatin (Crestor®), pravastatin (Pravachol®), simvastatin (Zocor®), fluvastatin (Lescol®), and lovastatin (Mevacor®), or any combination thereof. 
     
     
         7 . The method of  claim 1 , wherein said HMG-CoA reductase inhibitor comprises an HMG-CoA reductase inhibitor in combination with at least one additional therapeutic agent. 
     
     
         8 . The method of  claim 7 , wherein said HMG-CoA reductase inhibitor is selected from the group consisting of:
 simvastatin in combination with ezetimibe (Vytorin®);   lovastatin in combination with niacin (Advicor®);   atorvastatin in combination with amlodipine besylate (Caduet®); and   simvastatin in combination with niacin (Simcor®).   
     
     
         9 . The method of  claim 1 , wherein said nucleic acid is a nucleic acid extract from a biological sample from said human. 
     
     
         10 . The method of  claim 9 , wherein said biological sample is blood, saliva, or buccal cells. 
     
     
         11 . The method of  claim 9 , further comprising preparing said nucleic acid extract from said biological sample prior to said testing. 
     
     
         12 . The method of  claim 11 , further comprising obtaining said biological sample from said human prior to said preparing. 
     
     
         13 . The method of  claim 1 , wherein said testing comprises nucleic acid amplification. 
     
     
         14 . The method of  claim 13 , wherein said nucleic acid amplification is carried out by polymerase chain reaction. 
     
     
         15 . The method of  claim 1 , wherein said testing is performed using sequencing, 5′ nuclease digestion, molecular beacon assay, oligonucleotide ligation assay, size analysis, single-stranded conformation polymorphism analysis, or denaturing gradient gel electrophoresis (DGGE). 
     
     
         16 . The method of  claim 1 , wherein said testing is performed using an allele-specific method. 
     
     
         17 . The method of  claim 16 , wherein said allele-specific method is allele-specific probe hybridization, allele-specific primer extension, or allele-specific amplification. 
     
     
         18 . The method of  claim 1  which is an automated method. 
     
     
         19 . The method of  claim 1 , wherein said human is homozygous for said allele. 
     
     
         20 . The method of  claim 1 , wherein said human is heterozygous for said allele. 
     
     
         21 . The method of  claim 1 , wherein said CVD is coronary heart disease (CHD). 
     
     
         22 . The method of  claim 21 , wherein said CHD is myocardial infarction (MI). 
     
     
         23 . The method of  claim 1 , wherein said CVD is stroke. 
     
     
         24 . The method of  claim 1 , wherein said human did not have CVD prior to said testing. 
     
     
         25 . The method of  claim 1 , wherein said human did have CVD prior to said testing. 
     
     
         26 . The method of  claim 1 , further comprising administering an HMG-CoA reductase inhibitor to said human who has said allele. 
     
     
         27 . The method of  claim 1 , further comprising administering a therapeutic agent that is not an HMG-CoA reductase inhibitor to said human who does not have said allele, wherein said therapeutic agent is selected from the group consisting of niacin, fibrates, and ezetimibe (Zetia® or Ezetrol®). 
     
     
         28 . A method for determining whether a human's risk for cardiovascular disease (CVD) is reduced by treatment with an HMG-CoA reductase inhibitor, comprising:
 a) testing nucleic acid from said human for the presence or absence of an allele at a polymorphism as represented by position 101 of any one of the nucleotide sequences of SEQ ID NOS:623-3661 or its complement, wherein the presence of said allele indicates said human has an increased risk for CVD; and   b) correlating the presence of said allele with a reduction of said increased risk for CVD by an HMG-CoA reductase inhibitor.   
     
     
         29 . A method for determining whether a human has an increased risk for cardiovascular disease (CVD), comprising testing nucleic acid from said human for the presence or absence of an allele at a polymorphism as represented by position 101 of any one of the nucleotide sequences of SEQ ID NOS:623-3661 or its complement, wherein the presence of said allele indicates said human has an increased risk for CVD. 
     
     
         30 . The method of  claim 29 , further comprising administering an HMG-CoA reductase inhibitor to said human who has said increased risk for CVD. 
     
     
         31 . A method for reducing risk of cardiovascular disease (CVD) in a human, comprising administering to said human an effective amount of an HMG-CoA reductase inhibitor, wherein said human has been identified as having an allele at a polymorphism as represented by position 101 of any one of the nucleotide sequences of SEQ ID NOS:623-3661 or its complement, and wherein the presence of said allele indicates said human's risk for CVD is reduced by treatment with said HMG-CoA reductase inhibitor. 
     
     
         32 . The method of  claim 31 , wherein said method comprises testing nucleic acid from said human for the presence or absence of said allele. 
     
     
         33 . A method for determining whether a human's risk for cardiovascular disease (CVD) is reduced by treatment with an HMG-CoA reductase inhibitor or whether a human has an increased risk for CVD, the method comprising testing nucleic acid from said human for the presence or absence of an allele at an LD polymorphism that is in linkage disequilibrium of r 2 =0.9-1 with a first polymorphism as represented by position 101 of any one of the nucleotide sequences of SEQ ID NOS:623-3661 or its complement, wherein the presence of said allele indicates said human's risk for CVD is reduced by treatment with said HMG-CoA reductase inhibitor or said human has an increased risk for CVD. 
     
     
         34 . The method of  claim 33 , wherein said LD polymorphism is selected from the group consisting of the polymorphisms in Table 3. 
     
     
         35 . A detection reagent for carrying out the method of  claim 1 , wherein said detection reagent is an allele-specific probe or an allele-specific primer. 
     
     
         36 . A test kit comprising one or more containers containing the detection reagent of  claim 35  and one or more components selected from the group consisting of an enzyme, polymerase enzyme, ligase enzyme, buffer, amplification primer pair, dNTPs, ddNTPs, positive control nucleic acid, negative control, nucleic acid extraction reagent, and instructions for using said test kit which instruct that the presence of said allele indicates that said risk for CVD is reduced by treatment with said HMG-CoA reductase inhibitor. 
     
     
         37 . The method of  claim 1 , further comprising enrolling said human in a clinical trial of a therapeutic agent. 
     
     
         38 . The method of  claim 27 , wherein said therapeutic agent is being evaluated in a clinical trial.