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

   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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