Abstract P327: KIF6 Carrier Status in Asians Predicts Beneficial Response to Statins

Introduction: This is a prospective study of kif6, a genetic biomarker of cardiovascular disease and efficacy for statin therapy, using retrospective analysis of cardiac history. We explored the association between kif6 and cardiovascular disease (CVD) events (ACS, atherosclerosis with PCI or CABG) as well as the frequency of kif6 in Asians. In previous studies, carriers of kif6 had a higher incidence of CVD than non-carriers. The identification of a patient’s kif6 status may have impact on the therapeutic approach to reduce CVD risk. Hypothesis: Kif6 carriers with no or low dosage of statins have a higher rate of cardiovascular disease and treatment with higher dose statins have significant reduction in their rate of CVD events. Methods: We enrolled 135 patients from UCSF to determine kif6 carrier status and a review of their cardiac history. We analyzed the associations between high (40mg) vs. low (< 20 mg) in carriers and non-carriers and accounted for CVD events. For 11 patients, the statin dose at the time of their CVD event was unknown. Given the standard of care practice, this group was assigned to low statin. Result: Prevalence of kif6 mutation in Asians is 72%. Kif6-carriers with low/no statin have higher rates of CVD events (38%) compared to those on high dose statin (13%). Kif6-non carriers did not have significant reduction in CVD events with statin treatment. Study selection bias was a referral population from the community for secondary cardiovascular care at UCSF and small study size. However, enrollment is continuing. Other possible biases are presence of co-morbidities, e.g., smoking status, lifestyle habitus, Diabetes, and hypertension. Conclusion: This is the first prospective study looking at kif6 mutation prevalence and impact in Asians. The prevalence of kif6 mutation is high among Asians. Kif6-carrier is predictive of CVD events. There is definitive benefit of high-dose statin therapy for kif6-carriers with reduction in CVD events. There is no definitive benefit of statin therapy for non-carriers. Table Kif6-Carrier: (n= 97) Kif6-Non-carrier: (n=37) Low statin, no CVD event 46 15 Low statin, w/ CVD event 28 10 Total 74 25 Event rate 38% 40% High statin, no CVD event 20 9 High statin, w/ CVD event 3 3 Total 23 12 Event rate 13% 25% P-value 0.0468 0.5983