rs1333049

badMag 6.5

This is a intergenic variant variant in the CDKN2B-AS1 gene.

Key Literature Trait Associations

Coronary Artery Disease

The C allele at rs1333049 on chromosome 9p21.3 is one of the strongest and most replicated common genetic risk factors for coronary artery disease and myocardial infarction. Located near CDKN2A/CDKN2B, this locus regulates expression of the long non-coding RNA ANRIL (CDKN2B-AS1), which modulates vascular smooth muscle cell proliferation and atherosclerotic plaque stability. Homozygous CC carriers have an OR of approximately 1.47 for CAD compared to GG, confirmed across multiple independent GWAS and meta-analyses involving over 100,000 individuals.

Allele C
OR 1.30
p 1.0e-20
N 55,083
Meta-analysisLarge GWAS
multi-ancestry
Samani NJ et al. Genomewide association analysis of coronary artery disease. The New England Journal of Medicine 357(5):443-453 (2007)
Allele C
OR 1.47
p 1.8e-14
Large GWAS
Allele C
OR
β 0.188
p 2.0e-192
N 547,261
Large GWAS
European
Allele C
OR 1.24
p 6.0e-10
N 40,953
Meta-analysisLarge GWAS
European
Allele C
OR
p 2.0e-2
Meta-analysis
multi-ancestry

Myocardial Infarction

The 9p21.3 locus containing rs1333049 was identified as a major MI susceptibility locus by the deCODE genetics consortium in an Icelandic GWAS with replication across multiple European and US cohorts. The C allele confers an estimated per-allele OR of 1.28 for myocardial infarction. The risk is independent of traditional cardiovascular risk factors including lipids, blood pressure, diabetes, and BMI.

Allele C
OR 1.29
p 2.0e-20
N 82,000
Meta-analysisMajor Consortium StudyLarge GWAS
European
Helgadottir A et al. A common variant on chromosome 9p21 affects the risk of myocardial infarction. Science (new York, N.y.) 316(5830):1491-1493 (2007)
Allele C
OR 1.28
p 1.2e-20
Large GWAS
Allele C
OR
β 0.199 ±0.020
p 7.6e-19
N 9,961
Large GWAS
European

Atherosclerosis

rs1333049 is strongly associated with atherosclerosis across multiple vascular territories. A large 2024 VA Million Veteran Program GWAS (Verma et al., n=426,526–635,969 across ancestries) found genome-wide significant associations with general atherosclerosis (p=2×10⁻⁶¹, beta=0.161), atherosclerosis of the extremities (p=5×10⁻⁵⁴, beta=0.177), and atherosclerosis with claudication (p=2×10⁻⁴⁰), with the G allele being protective (inversely, C allele confers risk). The GWAS Catalog reports risk allele C with p=3×10⁻²⁴ for coronary artery calcification. These findings are consistent with the 9p21.3 locus influencing generalized arterial wall biology rather than being specific to a single vascular bed.

Verma A et al. Diversity and scale: Genetic architecture of 2068 traits in the VA Million Veteran Program. Science (new York, N.y.) 385(6706):eadj1182 (2024)
Allele C
OR
β 0.161
p 2.0e-61
N 635,969
Major Consortium StudyLarge GWAS
multi-ancestry
Allele C
OR
β 0.199 ±0.020
p 3.0e-24
N 9,961
Large GWAS
European

Ischemic stroke

The 9p21.3 locus shows shared genetic architecture between coronary artery disease and ischemic stroke, particularly the large-artery atherosclerosis subtype. Dichgans et al. 2014 (METASTROKE + CARDIoGRAM joint analysis, 12,389 stroke + 22,233 CAD cases) demonstrated genome-wide significant association for the combined CAD/ischemic stroke phenotype (p=1×10⁻⁵⁶). A 2022 meta-analysis (Bai et al., 25 studies, up to 23,743 participants) confirmed rs1333049 associated with IS risk primarily in Caucasian populations (OR ~1.16, 95% CI 1.08–1.25). The Zhao et al. 2017 meta-analysis (10 studies, 133,993 individuals) found a 16% increased cerebrovascular disease incidence per risk allele. The effect is most consistent for large-artery stroke and weaker for cardioembolic or small-vessel subtypes.

Allele C
OR
p 1.0e-56
N 56,855
Large GWAS
multi-ancestry
Zhao J et al. Association of CDKN2B-AS1 rs1333049 with Brain Diseases: A Case-control Study and a Meta-analysis. Clinical Psychopharmacology and Neuroscience : the Official Scientific Journal of the Korean College of Neuropsychopharmacology (2017)
Allele C
OR 1.16
p 1.0e-4
N 133,993
Meta-analysis
multi-ancestry

Endometriosis

The 9p21.3 locus harboring rs1333049 has been identified as one of the first susceptibility loci for endometriosis in GWAS. Pagliardini et al. 2013 combined an Italian case-control study (305 cases, 2,710 controls) with a meta-analysis of prior GWAS, confirming the G allele increases endometriosis risk (OR=1.32, 95% CI 1.11–1.57) in Caucasian women. Notably, the risk allele direction is opposite to the cardiovascular associations (G rather than C), suggesting independent regulatory effects at this locus or distinct linkage disequilibrium patterns. The mechanism may involve CDKN2B-AS1's role in cell proliferation and apoptosis in endometrial tissue.

GWAS Catalog Trait Associations (5)

Genome-wide significant associations (p < 5×10⁻⁸) from the NHGRI-EBI GWAS Catalog.

ClinVar annotation

Risk Factor
1 submitter

Three Vessel Coronary Disease

View on ClinVar →

Research that mentions this SNP (9)

Two-marker association tests yield new disease associations for coronary artery disease and hypertension
AssociationN=5,000Thomas P. Slavin et al.(2011)· Human Genetics

Two-marker association testing on WTCCC data identified SNP pairs associated with coronary artery disease (CAD) and hypertension (HTN). For CAD, three genes showed genome-wide significant associations: HFE2, STK32B, and DIP2C, plus a known region on 9p21 (CDKN2A/CDKN2B); HSP90B1 was found near a significant locus on chromosome 12. For HTN, five genes showed associations: GPR39, XRCC4, MYO6, ZFAT (with the lowest p-value in the study), and MACROD2, plus four non-protein-coding regions. Novel two-marker statistical methods revealed additional disease variants not detected by single-marker analysis alone.

Traits studied:Coronary artery diseaseHypertension
Common genetic polymorphisms in Moyamoya and atherosclerotic disease in Europeans
AssociationN=108Constantin Roder et al.(2011)· Child's Nervous System

Case-control study of 40 European Moyamoya disease patients versus 68 controls found a significant association between rs599839 (A/G, OR=2.17, 95% CI=1.17-4.05, p=0.01) in the PSRC1 gene and Moyamoya disease, along with three additional SNPs showing borderline significance in ELN and CXCL12 genes. The findings suggest shared genetic pathways between Moyamoya disease and atherosclerotic disease.

Traits studied:Atherosclerotic diseaseMoyamoya disease
The transcription factor GATA-2 does not associate with angiographic coronary artery disease in the Ottawa Heart Genomics and Cleveland Clinic GeneBank Studies
AssociationN=6,274Dandona S. et al.(2010)· Human Genetics

This association study tested whether GATA2 variants associate with sporadic coronary artery disease (CAD) in the Ottawa Heart Genomics Study and Cleveland Clinic populations, finding no significant association for rs2713604 or rs1573949. In 3,574 CAD cases and 2,700 controls, neither SNP showed association with angiographic CAD (p = 0.068 and p = 0.925, respectively), contradicting a prior family-based report.

Traits studied:Coronary artery diseaseMyocardial infarction
Use of longitudinal data in genetic studies in the genome‐wide association studies era: summary of Group 14
ReviewN=14,658Kerner B. et al.(2009)· Genetic Epidemiology

This is a summary of Group 14 analyses from the Genetic Analysis Workshop 16 (GAW16) demonstrating the use of longitudinal data from the Framingham Heart Study in genome-wide association studies. Multiple analytical approaches were compared for identifying genetic associations with metabolic and cardiovascular traits including BMI, type 2 diabetes, blood pressure, lipid levels, and coronary heart disease, using various statistical methods such as linear mixed models, growth mixture modeling, and generalized estimating equations.

Traits studied:Body Mass IndexCoronary Artery CalcificationCoronary Heart DiseaseHigh-Density LipoproteinLow-Density LipoproteinMetabolic SyndromeSystolic Blood PressureTriglyceridesType 2 DiabetesWeight
Association studies of 22 candidate SNPs with late‐onset Alzheimer's disease
AssociationN=2,019Figgins JA et al.(2009)· American Journal of Medical Genetics Part B: Neuropsychiatric Genetics

This replication study tested 22 candidate SNPs for association with late-onset Alzheimer's disease in 1,009 cases and 1,010 controls of Caucasian descent. While the primary analysis found no significant associations with AD risk, the study identified notable associations with age-at-onset (rs2074877 in MYH13, p=0.00196) and disease duration (rs41271951 in CTSS and rs41310885 in FAM63A, p=0.006 and p=0.0014, respectively).

Traits studied:Age-at-onsetDisease durationLate-onset Alzheimer's diseaseMini-Mental State Examination score
Sequence variants on chromosome 9p21.3 confer risk for atherosclerotic stroke
AssociationN=8,681Andreas Gschwendtner et al.(2009)· Annals of Neurology

This study identified seven SNPs on chromosome 9p21.3 associated with atherosclerotic stroke risk in 4,376 cases and 4,305 controls from Europe and North America. The lead SNP rs1537378 had a pooled odds ratio of 1.21 (95% CI=1.07-1.37, p=0.002) with a population attributable risk of 20.1% for atherosclerotic stroke. The associated variants are located in a region spanning over 100 kb that overlaps genes encoding ANRIL (antisense noncoding RNA), MTAP, CDKN2A, and CDKN2B, implicating this locus in vascular disease pathogenesis.

Traits studied:Atherosclerotic strokeCoronary artery diseaseIschemic strokeMyocardial infarction
The impact of newly identified loci on coronary heart disease, stroke and total mortality in the MORGAM prospective cohorts
AssociationN=33,282Juha Karvanen et al.(2009)· Genetic Epidemiology

Prospective cohort study of 33,282 individuals from the MORGAM Project investigating SNPs from recent GWAS in relation to incident coronary heart disease (CHD), stroke, and total mortality. SNP rs1333049 (9p21.3) was associated with both CHD (HR=1.20, 95% CI 1.08-1.34) and stroke, rs11670734 (19q12) with total mortality and stroke, and several SNPs associated with lipid levels and blood pressure.

Traits studied:Blood pressureCoronary heart diseaseHDL cholesterolMyocardial infarctionNon-HDL cholesterolStrokeTotal mortality
Pharmacogenetics: data, concepts and tools to improve drug discovery and drug treatment
ReviewJürgen Brockmöller et al.(2008)· European Journal of Clinical Pharmacology

This comprehensive review article traces the evolution of pharmacogenetics from single-gene analysis to whole-genome approaches. It discusses validated pharmacogenetic biomarkers with clinical impact including CYP2D6, CYP2C9, CYP2C19, TPMT, DPD, VKORC1, UGT1A1, and ADRB1/ADRB2, providing examples of how genetic variants affect drug metabolism and response. The paper emphasizes the importance of integrating pharmacogenetic information into clinical practice and drug development.

Traits studied:5-fluorouracil toxicityanticoagulant responseantidepressant responseasthmaatrial fibrillationbeta-blocker responsebreast cancerclopidogrel responsecolorectal cancerdrug metabolismdrug responsehypertensionirinotecan toxicitylung cancerproton pump inhibitor metabolismrheumatoid arthritisthiopurine toxicitythrombosis risktype 2 diabeteswarfarin sensitivity
The novel genetic variant predisposing to coronary artery disease in the region of the PSRC1 and CELSR2 genes on chromosome 1 associates with serum cholesterol
AssociationN=3,974Nilesh J. Samani et al.(2008)· Journal of Molecular Medicine

This genome-wide association study investigated whether seven CAD-associated loci affect coronary artery disease risk through traditional cardiovascular risk factors. The study found that rs599839, located near PSRC1 and CELSR2 on chromosome 1p13.3, showed a strong association with serum cholesterol levels, with the risk allele A associated with 0.17 mmol/l higher total cholesterol per allele copy (P = 3.84 × 10⁻⁶) and 0.19 mmol/l higher LDL cholesterol (P = 8.56 × 10⁻⁵). This association was replicated in independent cohorts and the findings support further investigation of these genes in cholesterol metabolism and coronary risk.

Traits studied:Blood pressureBlood urateBody mass indexCoronary artery diseaseCreatinine clearanceGlucoseHDL cholesterolLDL cholesterolMyocardial infarctionTotal cholesterolWaist-hip ratio

Gene information from NCBI Gene. Variant classifications from ClinVar.

Community Wiki

No community notes yet for this variant. Sign in to start one.

Comments

Sign in to join the discussion.

Loading comments…