Association of the Plasminogen Activator Inhibitor-1 Gene 4G/5G Polymorphism With ST Elevation Acute Myocardial Infarction in Young Patients

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• 作者：Irma Isordia-Salas ; Alfredo Leañ ; os-Mir ; a ; Irma M. Sainz ; Elba Reyes-Maldonado ; Gabriela Borrayo-Sá ; nchez
• 关键词：Fibrinolysis ; Myocardial infarction ; Thrombosis ; Plasminogen activator inhibitor-1 ; Coagulation
• 刊名：Revista Española de Cardiología (English Edition)
• 出版年：2009
• 出版时间：April 2009
• 年：2009
• 卷：62
• 期：4
• 页码：365-372
• 全文大小：258 K

文摘

class=""h4"">Introduction and objectives

To investigate the role of the 4G/5G polymorphism in the plasminogen activator inhibitor-1 (PAI-1) gene in patients with ST elevation myocardial infarction (STEMI) aged ≤45 years and its influence on regulation of the plasma PAI-1 concentration.

class=""h4"">Methods

This case-control study included 127 consecutive patients aged ≤45 years with a diagnosis of STEMI who were admitted to a cardiovascular intensive care unit and 127 controls recruited between January 2006 and March 2007. Participants were genotyped for the 4G/5G polymorphism using the polymerase chain reaction and restriction fragment length polymorphism analysis, and their plasma PAI-1 concentrations were measured. Informed consent was obtained from all participants.

class=""h4"">Results

There was a significant difference in genotype distribution between the 2 groups (Pc;.002). The 4G allele occurred more frequently in the patient group (P=.032). In addition, there were significant independent associations between STEMI and the 4G allele (ie, 4G/4G plus 4G/5G; odds ratio [OR] =2.29; 95 % confidence interval [CI], 1.12-4.68; P=.022), smoking (OR=23.23; 95 % CI, 8.92-60.47; Pc;.001), a family history of cardiovascular disease (OR=4.66; 95 % CI, 2.06-10.52; P=.001) and hypertension (OR=5.42; 95 % CI, 1.67-17.56; P=.005). The plasma PAI-1 concentration was higher in individuals who were homozygous for the 4G allele (Pc;.001).

class=""h4"">Conclusions

The study findings indicate that the 4G allele is an independent risk factor for acute myocardial infarction in young patients, as are smoking, hypertension, and a family history of inherited cardiovascular disease.