Circulating serum amyloid A levels but not SAA1 variants predict long-term outcomes of angiographically confirmed coronary artery disease

Kuan Hung Yeh, Lung An Hsu, Jyh Ming Jimmy Juang, Fu Tien Chiang, Ming Sheng Teng, I. Shiang Tzeng, Semon Wu, Jeng Feng Lin, Yu Lin Ko*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review


Objectives: Circulating serum amyloid A (SAA) levels are strongly associated with atherosclerotic cardiovascular disease risk and severity. The association between SAA1 genetic variants, SAA levels, inflammatory marker levels, and coronary artery disease (CAD) prognosis has not been fully understood. Materials and Methods: In total, 2199 Taiwan Biobank (TWB) participants were enrolled for a genome-wide association study (GWAS), and the long-term outcomes in 481 patients with CAD were analyzed. The primary endpoint was all-cause mortality, and the secondary endpoint was the combination of all-cause death, myocardial infarction, stroke, and hospitalization for heart failure. Results: Through GWAS, SAA1 rs11024600 and rs7112278 were independently associated with SAA levels (P = 3.84 × 10−145 and P = 1.05 × 10−29, respectively). SAA levels were positively associated with leukocyte counts and multiple inflammatory marker levels in CAD patients and with body mass index, hemoglobin, high-density lipoprotein cholesterol, and alanine aminotransferase levels in TWB participants. By stepwise linear regression analysis, SAA1 gene variants contributed to 27.53% and 8.07% of the variation of the SAA levels in TWB and CAD populations, respectively, revealing a stronger influence of these two variants in TWB participants compared to CAD patients. Kaplan–Meier survival analysis revealed that SAA levels, but not SAA1 gene variants, were associated with long-term outcomes in patients with CAD. Cox regression analysis also indicated that high circulating SAA levels were an independent predictor of both the primary and secondary endpoints. Conclusion: SAA1 genotypes contributed significantly to SAA levels in the general population and in patients with CAD. Circulating SAA levels but not SAA1 genetic variants could predict long-term outcomes in patients with angiographically confirmed CAD.

Original languageEnglish
Pages (from-to)423-433
Number of pages11
JournalTzu Chi Medical Journal
Issue number4
StatePublished - 01 10 2022

Bibliographical note

Publisher Copyright:
© 2022 Tzu Chi Medical Journal.


  • Coronary artery disease
  • Genome-wide association study
  • Long-term outcomes
  • SAA1 gene
  • Serum amyloid A


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