Isordia-Salas Irma, Leaños-Miranda Alfredo, Sainz Irma M, Reyes-Maldonado Elba, Borrayo-Sánchez Gabriela
Unidad de Investigación Médica en Trombosis, Hemostasia y Aterogénesis, Instituto Mexicano del Seguro Social, México DF, México.
Rev Esp Cardiol. 2009 Apr;62(4):365-72. doi: 10.1016/s1885-5857(09)71663-9.
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 < or =45 years and its influence on regulation of the plasma PAI-1 concentration.
This case-control study included 127 consecutive patients aged < or =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.
There was a significant difference in genotype distribution between the two groups (P< .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 (i.e., 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; P< .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 (P< .001).
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.
研究纤溶酶原激活物抑制剂-1（PAI-1）基因4G/5G多态性在年龄≤45岁的ST段抬高型心肌梗死（STEMI）患者中的作用及其对血浆PAI-1浓度调节的影响。
本病例对照研究纳入了127例年龄≤45岁、诊断为STEMI且入住心血管重症监护病房的连续患者，以及2006年1月至2007年3月招募的127名对照。采用聚合酶链反应和限制性片段长度多态性分析对参与者进行4G/5G多态性基因分型，并测量其血浆PAI-1浓度。所有参与者均获得了知情同意。
两组间基因型分布存在显著差异（P<0.002）。4G等位基因在患者组中出现的频率更高（P=0.032）。此外，STEMI与4G等位基因（即4G/4G加4G/5G；比值比[OR]=2.29；95%置信区间[CI]，1.12-4.68；P=0.022）、吸烟（OR=23.23；95%CI，8.92-60.47；P<0.001）、心血管疾病家族史（OR=4.66；95%CI，2.06-10.52；P=0.001）和高血压（OR=5.42；95%CI，1.67-17.56；P=0.005）之间存在显著的独立关联。4G等位基因纯合个体的血浆PAI-1浓度更高（P<0.001）。
研究结果表明，4G等位基因是年轻患者急性心肌梗死的独立危险因素，吸烟、高血压和遗传性心血管疾病家族史也是如此。
