Prothrombin G20210A (rs1799963) polymorphism increases myocardial infarction risk in an age-related manner: A systematic review and meta-analysis

Abstract

G20210A polymorphism (rs1799963) within the prothrombin gene is associated with a higher circulation level of prothrombin, thus increasing the likelihood of developing myocardial infarction (MI). Opinions differ regarding the correlation between prothrombin G20210A genotype and MI risk, which prompted us to conduct a meta-analysis to determine this association. PubMed, EMBASE, Web of Science and CNKI were searched for pertinent reports. A total of 34 studies involving 14 611 MI cases and 84 358 controls were analyzed in this quantitative analysis. We found a statistically significant association between prothrombin G20210A polymorphism and MI in the allele model (A vs. G, OR = 1.43, 95%CI: 1.18–1.72), heterozygote model (GA vs. GG, OR = 1.41, 95%CI: 1.16–1.72) and dominant model (GA + AA vs. GG, OR = 1.41, 95%CI: 1.15–1.72). The association remains significant in Caucasians but not in non-Caucasians. Moreover, prothrombin G20210A polymorphism increases MI risk in an age-related manner. A further significant association was found in a subpopulation younger than 55 years (allele model, OR = 1.76, 95%CI: 1.32–2.35; heterozygote model, OR = 1.70, 95%CI: 1.24–2.33; dominant model, OR = 1.70, 95%CI: 1.24–2.34). Sensitivity analysis and publication bias analysis revealed stable and statistically robust results. Our meta-analysis demonstrated that prothrombin G20210A polymorphism may represent a risk factor for MI.

Inherited thrombophilia and the risk of myocardial infarction: current evidence and uncertainties

“…39,40,53 A study by Ye at al, 43 including 8211 cases and 12 356 controls, confirmed that the presence of FII20210A represents a significant, but small risk for MI (OR, 1.25; 95% CI, 1.05-1.50). A more recent report by Li et al 54 (including a total of 33 studies with 13 488 cases and 77 085 controls) showed a similar, significant association between FII20210A and MI in the allele model (A vs G; OR, 1.43; 95% CI, 1.18-1.72) with almost identical results in the heterozygote (GA vs GG) or dominant model (GA+AA vs GG) as well. In this study, authors have performed subgroup analyses and found that the association remained significant in those of Caucasian origin.…”

Recurrent coronary syndromes in a patient with isolated very-high lipoprotein (a) and the prothrombin genetic variant rs1799963 (G20210A): a case report

“…Besides isolated Lp(a)-hyperlipoproteinaemia, our patient carries the prothrombin rs1799963 genetic variant associated with an increased risk of venous thromboembolism as well as with an increased overall risk of MI, an association markedly increased in young individuals and for which antiplatelet therapies seem to be the adequate treatment 3 …”

“…Lipoprotein (a) levels above 75 nmol/L (30 mg/dL) are considered pro-atherothrombotic and are found in 20% of the population 2 . Here, we report a young patient with severe recurrent episodes of coronary syndromes presenting with very-high circulating Lp(a) levels and the prothrombin rs1799963 (G20210A) genetic variant associated with an increased risk of thromboembolism 3 …”

Hemostatic Gene Polymorphisms in Acute Coronary Syndrome with Nonobstructive Coronary Atherosclerosis

“…Однако эта связь отсутствовала у больных старше 55 лет [30]. Доминирующая роль приобретенных факторов риска при ИМ, таких как дислипидемия, курение, ослабляла влияние генетического фактора у пожилых людей [37]. В проведенном нами иссле-довании полиморфизм гена G20210A регистрировался лишь в 1 (0,25 %) случае и не ассоциировался с увеличением риска развития ОИМ, что подтверждает результаты небольшого пилотного исследования, в котором больные с ОИМ при НАКА и стенозирующем атеросклерозе КА существенно не различались по частоте носительства неблагоприятных генотипов генов системы гемостаза [5].…”