Pegoraro R J, Ranjith N
Department of Chemical Pathology, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa.
Cardiovasc J S Afr. 2005 Sep-Oct;16(5):266-70.
The relationship between polymorphisms in the genes for plasminogen activator inhibitor type 1(PAI-1) and platelet glycoprotein IIIa (PGIIIa), clinical and environmental features, and the risk of premature coronary heart disease (CHD) in Asian Indian subjects living in South Africa, has been investigated.
The prevalence of the PAI-1 promoter 4G/5G and the PGIIIa PI A1A2 polymorphisms was examined in 195 unrelated Asian Indian patients ( <or= 45 years) who presented with myocardial infarction (MI). Results were compared with those from 107 unaffected siblings (18-45 years) and 300 healthy age- and race-matched control subjects.
Overall, neither the PAI-1 4G/5G nor the PGIIIa PI A1A2 polymorphism demonstrated an independent risk for MI. No synergistic effect was observed between these two polymorphisms when analysed together. There was a marginal association between the 4G allele of the PAI-1 gene and the risk of MI in individuals who smoked compared with non-smokers (26 vs 11%; p = 0.028; OR 2.74; 95% CI 1.04-8.47). The PGIIIa PI A2 allele was, however, strongly associated with a previous history of MI (17 vs 6%; p = 0.004; OR 3.00; 95% CI 1.38-6.46), as well as the severity of disease as determined by angiography (single/double- vs triple-vessel disease: 3% vs 15%; p = 0.020; OR 0.19; 95% CI 0.02-0.92).
In young Asian Indians who smoke, the PAI-1 4G allele is a mild risk factor for the development of MI. The PGIIIa PI A2 allele constitutes a significant risk for individuals who have a previous history of MI, as well as serving as an indicator for the severity of CHD.
已对居住在南非的亚洲印度裔人群中纤溶酶原激活物抑制剂1（PAI - 1）基因和血小板糖蛋白IIIa（PGIIIa）基因多态性、临床及环境特征与早发冠心病（CHD）风险之间的关系进行了研究。
检测了195名患有心肌梗死（MI）的不相关亚洲印度裔患者（年龄≤45岁）中PAI - 1启动子4G/5G和PGIIIa PI A1A2基因多态性的患病率。将结果与107名未患病的同胞（年龄18 - 45岁）以及300名年龄和种族匹配的健康对照者的结果进行比较。
总体而言，PAI - 1 4G/5G和PGIIIa PI A1A2基因多态性均未显示出MI的独立风险。当一起分析这两种多态性时，未观察到协同效应。与不吸烟者相比，PAI - 1基因的4G等位基因与吸烟个体发生MI的风险之间存在微弱关联（26%对11%；p = 0.028；OR 2.74；95% CI 1.04 - 8.47）。然而，PGIIIa PI A2等位基因与既往MI病史密切相关（17%对6%；p = 0.004；OR 3.00；95% CI 1.38 - 6.46），并且与血管造影确定的疾病严重程度相关（单支/双支血管病变与三支血管病变：3%对15%；p = 0.020；OR 0.19；95% CI 0.02 - 0.92）。
在吸烟的年轻亚洲印度裔人群中，PAI - 1 4G等位基因是MI发生的轻度危险因素。PGIIIa PI A2等位基因对有既往MI病史的个体构成显著风险，并且可作为CHD严重程度的指标。
