45岁前后的心肌梗死：血小板受体多态性的可能作用

Myocardial infarction before and after the age of 45: Possible role of platelet receptor polymorphisms.

作者信息

Pina-Cabral Luís B, Carvalhais Virgínia, Mesquita Bárbara, Escórcio Cláudia, Silva Paulo F, Pinto Paula, Napoleão Patrícia, Pinheiro Teresa, Monteiro Maria C, Almeida-Dias António, Criado Begoña

机构信息

Instituto de Investigação e Formação Avançada em Ciências e Tecnologias da Saúde, Gandra, Portugal.

出版信息

Rev Port Cardiol (Engl Ed). 2018 Sep;37(9):727-735. doi: 10.1016/j.repc.2018.03.015. Epub 2018 Aug 22.

DOI:10.1016/j.repc.2018.03.015

PMID:30143348

Abstract

INTRODUCTION

We examined the potential role of polymorphisms of the platelet genes GP1BA (rs2243093, rs6065 and VNTR), ITGB3 (rs5918), ITGA2 (rs938043469) and P2RY12 (rs2046934, rs6801273 and rs6798347) as risk factors for myocardial infarction (MI).

METHODS

The study population was divided into three groups: controls (n=235), MI at age ≤45 years (MI ≤45, n=44), and MI at age >45 years (MI >45, n=78). The control group was further divided into two subgroups (control ≤45 and >45), and subgroups including only men were also considered for statistical analysis. Polymorphisms were detected by polymerase chain reaction and restriction fragment length polymorphism analysis.

RESULTS

Regarding non-genetic risk factors, the control group differed statistically from the MI ≤45 group (p<00.5) in terms of smoking, hypertension, diabetes and obesity, and from the MI >45 group (p<0.05) in terms of hypertension, diabetes, obesity, family history of thrombosis and high cholesterol. For the studied ITGA2 polymorphism, a statistical difference was found when MI >45 was compared with the control group, with a higher risk of MI in the TT genotype (OR 2.852; 95% CI: 1.092-7.451; p=0.032). In the GP1BA rs6065 polymorphism, a statistically significant difference was found between control ≤45 only men and MI ≤45 only men, with a higher risk in the CT genotype (OR 5.568; 95% CI: 1.421-21.822; p=0.016), despite the low numbers included. The other polymorphisms studied did not show any statistically significant correlations.

CONCLUSION

There is a statistically significant association between the TT genotype of the ITGA2 rs938043469 polymorphism and increased risk for MI >45.

摘要

引言

我们研究了血小板基因GP1BA（rs2243093、rs6065和可变数目串联重复序列）、ITGB3（rs5918）、ITGA2（rs938043469）和P2RY12（rs2046934、rs6801273和rs6798347）的多态性作为心肌梗死（MI）危险因素的潜在作用。

方法

研究人群分为三组：对照组（n = 235）、年龄≤45岁的心肌梗死患者（MI≤45，n = 44）和年龄>45岁的心肌梗死患者（MI>45，n = 78）。对照组进一步分为两个亚组（年龄≤45岁和>45岁的对照组），并且还对仅包括男性的亚组进行了统计分析。通过聚合酶链反应和限制性片段长度多态性分析检测多态性。

结果

关于非遗传危险因素，对照组在吸烟、高血压、糖尿病和肥胖方面与MI≤45组存在统计学差异（p<0.05），在高血压、糖尿病、肥胖、血栓形成家族史和高胆固醇方面与MI>45组存在统计学差异（p<0.05）。对于所研究的ITGA2多态性，当将MI>45组与对照组进行比较时发现存在统计学差异，TT基因型的心肌梗死风险更高（比值比2.852；95%置信区间：1.092 - 7.451；p = 0.032）。在GP1BA rs6065多态性中，仅年龄≤45岁男性的对照组与仅年龄≤45岁男性的MI组之间存在统计学显著差异，CT基因型的风险更高（比值比5.568；95%置信区间：1.421 - 21.822；p = 0.016），尽管纳入的数量较少。所研究的其他多态性未显示任何统计学显著相关性。