Gardemann A, Humme J, Stricker J, Nguyen Q D, Katz N, Philipp M, Tillmanns H, Hehrlein F W, Rau M, Haberbosch W
Institut für Klinische Chemie und Pathobiochemie, Justus-Liebig-Universität Giessen, Germany.
Thromb Haemost. 1998 Aug;80(2):214-7.
The platelet membrane glycoprotein IIb/IIIa functions as a receptor for fibrinogen and von Willebrand factor during platelet aggregation. In a small case-control study, evidence has been presented that the PlA2 allele of the platelet glycoprotein GPIIIa PlA/A2 gene polymorphism might be an independent risk factor for acute myocardial infarction (MI).
We explored the association of the PlA1A2 to the severity of coronary artery disease (CAD), as assessed angiographically in 2252 male individuals, and to myocardial infarction (MI). The severity of coronary heart disease (CHD) was also estimated by calculating a CHD score according to Gensini. The PlA genotype was determined by allele specific restriction digestion. Relation of the PlA2 allele to CAD: In the total population, the frequency of the PlA2 allele was not associated to the presence or to the extent of CAD. Also the CHD scores of PlA1/PlA2 genotypes were essentially the same. However, after exclusion of individuals with high BMI (> or =26.9 kg/m2) and/or low apoAI (< 1.43 g/l) PlA2PlA2 carriers had clearly higher CHD scores than PlA1PlA1 genotypes: PlA1PlA2 heterozygotes had intermediate values (p <0.05). After division of the study population into one group of individuals without any angiographic signs of CAD (CHD score = 0) and into another group of patients with severe CAD (CHD score (> or = 120), a strong association of the PlA2 allele with severe CAD was also found in the same low risk groups: e.g. exclusion of persons with high BMI and low apoAI resulted in an Odds ratio of 5.37 (1.46-19.7) (p <0.02). Relation of the PlA2 allele to MI: No association was found between PlA1/PlA2 genotypes and risk of MI neither in the total population nor in low risk subgroups.
Whereas no difference in the distribution of allele and genotype frequencies between controls and survivors of MI could be detected, the PlA2 allele is associated with CHD in low risk patients.
血小板膜糖蛋白IIb/IIIa在血小板聚集过程中作为纤维蛋白原和血管性血友病因子的受体。在一项小型病例对照研究中，有证据表明血小板糖蛋白GPIIIa PlA/A2基因多态性的PlA2等位基因可能是急性心肌梗死（MI）的独立危险因素。
我们探讨了PlA1A2与冠状动脉疾病（CAD）严重程度（通过血管造影评估2252名男性个体）以及与心肌梗死（MI）之间的关联。还根据Gensini计算冠心病（CHD）评分来估计冠心病（CHD）的严重程度。通过等位基因特异性限制性消化确定PlA基因型。PlA2等位基因与CAD的关系：在总体人群中，PlA2等位基因的频率与CAD的存在或程度无关。PlA1/PlA2基因型的CHD评分也基本相同。然而，排除高BMI（≥26.9 kg/m2）和/或低载脂蛋白AI（<1.43 g/l）的个体后，PlA2PlA2携带者的CHD评分明显高于PlA1PlA1基因型：PlA1PlA2杂合子具有中间值（p<0.05）。将研究人群分为一组无任何CAD血管造影迹象（CHD评分为0）的个体和另一组严重CAD（CHD评分≥120）的患者后，在相同的低风险组中也发现PlA2等位基因与严重CAD有很强的关联：例如，排除高BMI和低载脂蛋白AI的人后，优势比为5.37（1.46 - 19.7）（p<0.02）。PlA2等位基因与MI的关系：在总体人群和低风险亚组中，均未发现PlA1/PlA2基因型与MI风险之间存在关联。
虽然在MI幸存者与对照组之间未检测到等位基因和基因型频率分布的差异，但PlA2等位基因与低风险患者的CHD相关。
