Department of Internal Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam.
Department of Cardiology, Cho Ray Hospital, Ho Chi Minh City, Vietnam.
PLoS One. 2024 Apr 18;19(4):e0300273. doi: 10.1371/journal.pone.0300273. eCollection 2024.
The pathogenesis and prognosis of patients with acute myocardial infarction (AMI) may be influenced by both genetic and environmental factors. Findings on the relationship of polymorphisms in various genes encoding the renin-angiotensin-aldosterone system with coronary artery lesions and mortality in AMI patients are inconsistent. The aim of this study was to determine whether the AGTR1 A1166C genetic polymorphism affects coronary artery lesions and 1-year mortality in post-AMI patients. Patients with their first AMI admitted to Cho Ray Hospital, Vietnam, from January 2020 to August 2021 were enrolled in this prospective clinical study. All participants underwent invasive coronary angiography and were identified as having the genotypes of AGTR1 A1166C by way of a polymerase chain reaction method. All patients were followed up for all-cause mortality 12 months after AMI. The association of the AGTR1 A1166C polymorphism with coronary artery lesions and 1-year mortality was evaluated using logistic regression and Cox regression analysis, respectively. Five hundred and thirty-one AMI patients were recruited. The mean age was 63.9 ± 11.6 years, and 71.6% of the patients were male. There were no significant differences in the location and number of diseased coronary artery branches between the AA and AC+CC genotypes. The AC and CC genotypes were independently associated with ≥ 90% diameter stenosis of the left anterior descending (LAD) artery (odds ratio = 1.940; 95% confidence interval (CI): 1.059-3.552, p = 0.032). The 1-year all-cause mortality rate difference between patients with the AC and CC genotypes versus those with the AA genotype was not statistically significant (hazard ratio = 1.000, 95% CI: 0.429-2.328, p = 1.000). The AGTR1 A1166C genetic polymorphism is associated with very severe luminal stenosis of the LAD but not with mortality in AMI patients.
急性心肌梗死(AMI)患者的发病机制和预后可能受到遗传和环境因素的影响。关于各种编码肾素-血管紧张素-醛固酮系统的基因多态性与 AMI 患者冠状动脉病变和死亡率之间关系的研究结果并不一致。本研究旨在确定 AGTR1 A1166C 基因多态性是否影响 AMI 后患者的冠状动脉病变和 1 年死亡率。
这项前瞻性临床研究纳入了 2020 年 1 月至 2021 年 8 月期间在越南顺化中央医院首次诊断为 AMI 的患者。所有患者均接受了冠状动脉造影检查,并通过聚合酶链反应方法确定了 AGTR1 A1166C 的基因型。所有患者均在 AMI 后 12 个月进行了全因死亡率随访。采用 logistic 回归和 Cox 回归分析分别评估了 AGTR1 A1166C 多态性与冠状动脉病变和 1 年死亡率的关系。
共纳入 531 例 AMI 患者,平均年龄为 63.9±11.6 岁,71.6%为男性。AA 和 AC+CC 基因型患者的病变冠状动脉分支部位和数量无显著差异。AC 和 CC 基因型与左前降支(LAD)≥90%直径狭窄独立相关(比值比=1.940;95%置信区间:1.059-3.552,p=0.032)。AC 和 CC 基因型患者与 AA 基因型患者的 1 年全因死亡率差异无统计学意义(风险比=1.000,95%置信区间:0.429-2.328,p=1.000)。
AGTR1 A1166C 基因多态性与 LAD 非常严重的管腔狭窄相关,但与 AMI 患者的死亡率无关。