Genetic variations associated with coronary artery disease and myocardial infarction in the Arab world: a systematic review and meta-analysis

Abstract

Coronary artery disease (CAD) and myocardial infarction (MI) have reached epidemic levels in the Arab world. The well-recognized familial clustering of CAD implies that genetics plays a key role in its development. Several CAD/MI genetic association studies have been conducted, but the outcomes have been inconsistent. In this study, we aimed to systematically review and quantitatively summarize the current evidence on genetic polymorphisms associated with CAD/MI risk in the Arab world. We systematically searched five literature databases (Science Direct, PubMed, Scopus, EMBASE, and Web of Science). We included all genetic polymorphisms with odds ratio (OR) > 1 that were significantly associated with CAD/MI risk among Arabs. Review Manager software v5.02 was used to conduct the meta-analysis. Publication bias was measured using Begg’s funnel plot and Egger’s test based on STATA software v15.1. The pooled odds ratios (ORs) and 95% confidence intervals (CIs) were computed to estimate the association. I2-statistic was used to assess heterogeneity. In total, 75 studies comprising 36,125 cases and 31,730 controls were included, and 62 studies were eligible for meta-analysis. A total of 80 captured variants within or near 59 genes were found to be associated with an increased CAD/MI susceptibility. We performed 46 individual meta-analyses tests for 46 variants. The pooled OR of association with CAD/MI ranged from 1.14 to 7.57, with a median (interquartile range) of 1.83 (1.64 – 2.57). With the few studies published so far, there appears to be a unique genetic and clinical susceptibility profile for Arab patients with CAD/MI. The findings of this study will pave the way to perform future genetic association studies that will help identify potential therapeutic targets against CAD/MI.