Žaliaduonytė-Pekšienė Diana, Lesauskaitė Vaiva, Liutkevičienė Rasa, Tamakauskas Vytenis, Kviesulaitis Vilius, Šinkūnaitė-Maršalkienė Giedrė, Šimonytė Sandrita, Mačiulskytė Simonita, Tamulevičiūtė-Prascienė Eglė, Gustienė Olivija, Tamošiūnas Abdonas, Žaliūnas Remigijus
1 Department of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Lithuania.
2 Institute of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Lithuania.
J Renin Angiotensin Aldosterone Syst. 2017 Oct-Dec;18(4):1470320317739987. doi: 10.1177/1470320317739987.
To evaluate the influence of traditional risk factors of ischaemic heart disease and genetic factors to predict different types of acute coronary syndromes.
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.
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.
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.
评估缺血性心脏病的传统危险因素和遗传因素对预测不同类型急性冠脉综合征的影响。
研究组包括523例急性冠脉综合征患者（393例ST段抬高型心肌梗死（STEMI）患者和130例非ST段抬高型心肌梗死（NSTEMI）患者）。对照组由645例无缺血性心脏病和中风症状的受试者组成。采用聚合酶链反应评估基质金属蛋白酶-2（MMP-2）（-735）C/T、MMP-2（-1306）C/T、MMP-3（-1171）5A/6A、MMP-9（-1562）C/T和血管紧张素转换酶（ACE）I/D的基因多态性。
与对照组相比，急性冠脉综合征患者ACE基因的ID或II基因型比DD基因型更常见（P = 0.04），MMP-3基因的5A5A或5A6A基因型比6A6A基因型更常见（P = 0.02）。其他基质金属蛋白酶基因的基因型在两组之间无差异。MMP-3的5A5A和5A6A基因型（优势比（OR）1.5；P = 0.021）、ACE的II和ID基因型（OR 1.7；P = 0.006）以及吸烟（OR 4.9；P = 0.001）、高血压（OR 2.0；P = 0.001）、糖尿病（OR 2.9；P = 0.001）和血脂异常（OR 2.1；P = 0.001）等传统缺血性心脏病危险因素增加了STEMI的风险。然而，MMP-3 5A/6A和ACE I/D的基因多态性与NSTEMI的发生无关。
MMP-3 5A/6A和ACE I/D的基因多态性以及传统缺血性心脏病危险因素增加了STEMI发生的风险，而对NSTEMI的发病机制无影响。
