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充血性心力衰竭患者基因多态性与植入式左心室辅助装置并发症的关联:一项哈萨克斯坦的研究。

Association of Genetic Polymorphisms with Complications of Implanted LVAD Devices in Patients with Congestive Heart Failure: A Kazakhstani Study.

作者信息

Zhalbinova Madina R, Rakhimova Saule E, Kozhamkulov Ulan A, Akilzhanova Gulbanu A, Kaussova Galina K, Akilzhanov Kenes R, Pya Yuriy V, Lee Joseph H, Bekbossynova Makhabbat S, Akilzhanova Ainur R

机构信息

National Laboratory Astana, Nazarbayev University, Nur-Sultan 010000, Kazakhstan.

Department of General Biology and Genomics, L. N. Gumilyov Eurasian National University, Nur-Sultan 010000, Kazakhstan.

出版信息

J Pers Med. 2022 May 4;12(5):744. doi: 10.3390/jpm12050744.

Abstract

The left ventricular assist device (LVAD) is one of the alternative treatments for heart failure (HF) patients. However, LVAD support is followed by thrombosis, and bleeding complications which are caused by high non-physiologic shear stress and antithrombotic/anticoagulant therapy. A high risk of complications occurs in the presence of the genotype polymorphisms which are involved in the coagulation system, hemostasis function and in the metabolism of the therapy. The aim of the study was to investigate the influence of single-nucleotide polymorphisms (SNP) in HF patients with LVAD complications. We analyzed 21 SNPs in HF patients ( = 98) with/without complications, and healthy controls ( = 95). SNPs rs9934438; rs9923231 in , rs5918 in and rs2070959 in demonstrated significant association with HF patients' complications (OR (95% CI): 3.96 (1.42-11.02), = 0.0057), (OR (95% CI): 3.55 (1.28-9.86), = 0.011), (OR (95% CI): 5.37 (1.79-16.16), = 0.0056) and OR (95% CI): 4.40 (1.06-18.20), = 0.044]. Genotype polymorphisms could help to predict complications at pre- and post-LVAD implantation period, which will reduce mortality rate. Our research showed that patients can receive treatment with warfarin and aspirin with a personalized dosage and LVAD complications can be predicted by reference to their genotype polymorphisms in , and genes.

摘要

左心室辅助装置(LVAD)是心力衰竭(HF)患者的替代治疗方法之一。然而,LVAD支持治疗后会出现血栓形成以及由高非生理性剪切应力和抗血栓/抗凝治疗引起的出血并发症。在参与凝血系统、止血功能和治疗代谢的基因型多态性存在的情况下,会出现高并发症风险。本研究的目的是调查单核苷酸多态性(SNP)对LVAD并发症HF患者的影响。我们分析了有/无并发症的HF患者(n = 98)和健康对照者(n = 95)中的21个SNP。凝血因子Ⅶ中的SNP rs9934438、rs9923231,凝血因子Ⅴ中的rs5918以及凝血酶原基因中的rs2070959与HF患者的并发症显著相关(比值比(95%可信区间):3.96(1.42 - 11.02),P = 0.0057)、(比值比(95%可信区间):3.55(1.28 - 9.86),P = 0.011)、(比值比(95%可信区间):5.37(1.79 - 16.16),P = 0.0056)和(比值比(95%可信区间):4.40(1.06 - 18.20),P = 0.044)。基因型多态性有助于预测LVAD植入前后的并发症,这将降低死亡率。我们的研究表明,患者可以接受个性化剂量的华法林和阿司匹林治疗,并且可以通过参考他们在凝血因子Ⅶ、Ⅴ和凝血酶原基因中的基因型多态性来预测LVAD并发症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2dad/9143784/8291a72b658b/jpm-12-00744-g001.jpg

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