Association of the genetic and traditional risk factors of ischaemic heart disease with STEMI and NSTEMI development

Abstract

Introduction:To evaluate the influence of traditional risk factors of ischaemic heart disease and genetic factors to predict different types of acute coronary syndromes.Materials and methods:Five hundred and twenty-three patients with acute coronary syndromes (393 with ST elevation myocardial infarction (STEMI) and 130 with non-ST elevation myocardial infarction (NSTEMI)) comprised the study group. The control group consisted of 645 subjects free from symptoms of ischaemic heart disease and stroke. Genetic polymorphisms of MMP-2 (–735) C/T, MMP-2 (–1306) C/T, MMP-3 (–1171) 5A/6A, MMP-9 (–1562) C/T and ACE I/D were evaluated using polymerase chain reaction.Results:Patients with acute coronary syndromes more often had ID or II genotype than DD genotype of ACE (P = 0.04) and 5A5A or 5A6A genotype than 6A6A genotype of MMP-3 (P = 0.02) in comparison to the control group. The genotypes of other matrix metalloproteinase genes did not differ between the groups. 5A5A and 5A6A genotypes of MMP-3 (odds ratio (OR) 1.5; P = 0.021), II and ID genotypes of ACE (OR 1.7; P = 0.006) along with traditional ischaemic heart disease risk factors such as smoking (OR 4.9; P = 0.001), hypertension (OR 2.0; P = 0.001), diabetes mellitus (OR 2.9; P = 0.001) and dyslipidaemia (OR 2.1; P = 0.001) increased the risk of STEMI. However, the polymorphism of MMP-3 5A/6A and ACE I/D was not associated with the occurrence of NSTEMI.Conclusions:Genetic polymorphisms of MMP-3 5A/6A and ACE I/D along with conventional ischaemic heart disease risk factors increase the risk of the occurrence of STEMI, while having no influence on the pathogenesis of NSTEMI.

Association of Factor II G20210A, Factor V G1691A and methylenetetrahydrofolate reductase C677T gene polymorphism with different forms of myocardial infarction: ST segment elevation and non-ST segment elevation

“…Patients from our study showed no difference according to the traditional risk factors (hypertension, diabetes mellitus, hypercholesterolemia, BMI, history of smoking and positive family history, for developing CAD and MI, in groups of STEMI and NSTEMI.Similar results were published in study of Ţaliaduonytė-Pekšienė D et al (22). No difference according to the coronary risk factors among patients with STEMI and NSTEMI were obtained in the study of Miyachi H et al (23).…”

Prognostic Value of Cortisol Index of Endobiogeny in Acute Myocardial Infarction Patients

“…The cortisol index may be valuable at the discrimination of high versus low risk patients after AMI. The results of other studies demonstrate that other prognostic markers, such as troponin I and T, natriuretic brain peptides, cortisol, and even the genetic background, may be important if we wish to assess the risk of the fatal outcome [34]. However, our data demonstrates that the cortisol index if comparing to troponin I and cortisol is the most valuable predictor of mortality after AMI with high sensitivity and specificity.…”

Differential gene expression patterns in ST-elevation Myocardial Infarction and Non-ST-elevation Myocardial Infarction

“…Although the diagnosis of MI has risen considerably by applying some specific gene biomarkers such as cardiac Troponin T/I, and CK-MB, but these biomarkers are not specific to distinguish NSTEMI and STEMI. Interestingly, NSTEMI and STEMI have different pathophysiologic conditions, indicating that the development and occurrence of MI may be strongly dependent on the different signaling pathways 26 , 27 . Therefore, the research on NSTEMI/STEMI-related genes may improve the diagnosis and treatment strategies.…”