ROLE OF GENETIC POLYMORPHISMS ASSOCIATED WITH LIPID DISORDERS AND ARTERIAL HYPERTENSION IN THE ASSESSMENT OF CLINICAL SEVERITY AND IN-HOSPITAL PROGNOSIS IN PATIENTS WITH ST-SEGMENT ELEVATION MYOCARDIAL INFARCTION
A.A. Inozemtseva1, V.V. Kashtalap1, L.A. Gordeeva2, E.N. Usoltseva1, O.V. Gruzdeva1, N.A. Terenteva3, O.L. Barbarash4,5
1FSBI В«Research Institute for Complex Issues of Cardiovascular Diseases»
nastya060988@yandex.ru
2FSBI В«Institute of Human Ecology» SB RAS, 650029, Kemerovo, Leningradski av., 10
gorsib@rambler.ru
3Kemerovo State Medical Academy, 650029, Kemerovo, Voroshilov str., 22A
queentna@gmail.ru
4FSBI В«Research Institute for Complex Issues of Cardiovascular Diseases», 650029, Kemerovo, Voroshilov str., 22A
olb61@mail.ru
5Kemerovo State Medical Academy
Keywords: myocardial infarction, genetic polymorphism, prognosis, lipid metabolism, prognosis
Abstract
Objective: To study the clinical and prognostic significance of gene polymorphisms APOA1 rs670, APOA5 rs662799 and ACE rs4341 in patients with ST-segment elevation myocardial infarction. Materials and Methods: 358 patients admitted with STEMI and undergoing diagnosis and treatment at the Kemerovo Cardiology Clinic were included in the study. Blood samples were collected at days 2-14 for genotyping. Clinical and demographic data, laboratory and instrumental findings were assessed. Data analysis was performed using the STATISTICA program (version 8.0; StatSoft, Tulsa, Oklahoma) and the genetic calculators (GeneXpert) with the construction of different inheritance models. Results: The carriers of the CC genotype of gene APOA5 demonstrated significantly higher triglyceride levels, whereas the level of high density lipoprotein cholesterol was lower in the carriers of the CC-genotype. The carriers of the GG genotype had a 3-fold increased risk of recurrent myocardial infarction (OR = 2.99, 95 % CI = 1.33-6.73, p = 0.006), and a 2.12-fold increased risk of early post-infarction angina, pulmonary edema and in-hospital death (OR = 2.12, 95 % CI = 1.14-3.94, p = 0.02). Allele D of gene ACE was associated with thickening intima-media complex of carotid arteries (OR = 1,65, 95 % CI = 1,04-2,61, p = 0,03). Conclusion: The polymorphic variants of genes associated with lipid metabolism disorders ( APOA1, APOA5 ) and arterial hypertension ( ACE ) may be used to assess the clinical severity and in-hospital prognosis in patients with myocardial infarction.
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