Sionova Magdalena, Blasko Peter, Jirous Stepan, Vindis David, Rokyta Richard, Motovska Zuzana
Third Faculty of Medicine, Faculty Hospital, Kralovske Vinohrady, Czech Republic.
Faculty of Medicine, University Hospital, Ostrava, Czech Republic.
Postepy Kardiol Interwencyjnej. 2017;13(3):202-209. doi: 10.5114/aic.2017.70187. Epub 2017 Sep 25.
Periprocedural bleeding related to coronary angiography (CAG) or percutaneous coronary intervention (PCI) is associated with worse prognosis. Determining genetic variations associated with increased bleeding risk may help to identify high-risk patients.
To analyse the association between single nucleotide polymorphisms (SNPs) of crucial haemostatic platelet receptors (GPIa, GPVI, P2Y12) and the risk of periprocedural bleeding complications related to CAG/PCI.
The population consisted of 73 patients with ischaemic heart disease who developed bleeding complications within 30 days after CAG/PCI and 331 patients without bleeding. The frequency of SNPs of GPIa 807C/T, GPVI 13254T/C, P2Y12 32C/T, and P2Y12 H1/H2 haplotype was analysed using polymerase chain reaction (PCR) hybridization methods.
The prevalence of variant alleles GPIa 807T, GPVI 13254C, P2Y12 34T, and P2Y12 H2 haplotype in the total study population was 56.7%, 20.3%, 56.2%, and 24.3%, respectively. The presence of variant alleles was not related to increased risk of periprocedural bleeding: GPIa 807C/T (OR = 1.29, 95% CI: 0.75-2.24, = 0.334), GPVI 12354T/C (OR = 0.82, 95% CI: 0.40-1.64, = 0.551), P2Y12 34C/T (OR = 0.71, 95% CI: 0.42-1.22, = 0.189), P2Y12 H1/H2 haplotype (OR = 0.69, 95% CI: 0.35-1.36, = 0.258). The frequency of the homozygous form of P2Y12 H2 haplotype was higher in the group of patients who developed bleeding (OR = 2.79, 95% CI: 0.51-13.77, = 0.161).
No significant association of the SNPs of GPIa 807C/T, GPVI 13254T/C, P2Y12 32C/T, and P2Y12 H1/H2 haplotype with increased risk of periprocedural bleeding was found in patients with ischaemic heart disease undergoing CAG/PCI.
与冠状动脉造影(CAG)或经皮冠状动脉介入治疗(PCI)相关的围手术期出血与更差的预后相关。确定与出血风险增加相关的基因变异可能有助于识别高危患者。
分析关键止血血小板受体(GPIa、GPVI、P2Y12)的单核苷酸多态性(SNP)与CAG/PCI相关围手术期出血并发症风险之间的关联。
研究人群包括73例缺血性心脏病患者,这些患者在CAG/PCI后30天内出现出血并发症,以及331例未出血的患者。使用聚合酶链反应(PCR)杂交方法分析GPIa 807C/T、GPVI 13254T/C、P2Y12 32C/T和P2Y12 H1/H2单倍型的SNP频率。
在整个研究人群中,变异等位基因GPIa 807T、GPVI 13254C、P2Y12 34T和P2Y12 H2单倍型的患病率分别为56.7%、20.3%、56.2%和24.3%。变异等位基因的存在与围手术期出血风险增加无关:GPIa 807C/T(OR = 1.29,95%CI:0.75 - 2.24,P = 0.334),GPVI 12354T/C(OR = 0.82,95%CI:0.40 - 1.64,P = 0.551),P2Y12 34C/T(OR = 0.71,95%CI:0.42 - 1.22,P = 0.189),P2Y12 H1/H2单倍型(OR = 0.69,95%CI:0.35 - 1.36,P = 0.258)。在发生出血的患者组中,P2Y12 H2单倍型纯合形式的频率更高(OR = 2.79, 95%CI:0.51 - 13.77,P = 0.161)。
在接受CAG/PCI的缺血性心脏病患者中,未发现GPIa 807C/T、GPVI 13254T/C、P2Y12 32C/T和P2Y12 H1/H2单倍型的SNP与围手术期出血风险增加有显著关联。