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Khawaja M, Siddiqui R, Virani SS, Amos CI, Bandyopadhyay D, Virk HUH, Alam M, Jneid H, Krittanawong C. Integrative Genetic Approach Facilitates Precision Strategies for Acute Myocardial Infarction. Genes (Basel) 2023; 14:1340. [PMID: 37510245 PMCID: PMC10379681 DOI: 10.3390/genes14071340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 06/12/2023] [Accepted: 06/22/2023] [Indexed: 07/30/2023] Open
Abstract
Acute myocardial infarction remains a significant cause of mortality worldwide and its burden continues to grow. Its pathophysiology is known to be complex and multifactorial, with several acquired and inherited risk factors. As advances in technology and medical therapy continue, there is now increasing recognition of the role that genetics play in the development and management of myocardial infarction. The genetic determinants of acute coronary syndrome are still vastly understudied, but the advent of whole-genome scanning and genome-wide association studies has significantly expanded the current understanding of genetics and simultaneously fostered hope that genetic profiling and gene-guided treatments could substantially impact clinical outcomes. The identification of genes associated with acute myocardial infarction can help in the development of personalized medicine, risk stratification, and improved therapeutic strategies. In this context, several genes have been studied, and their potential involvement in increasing the risk for acute myocardial infarction is being investigated. As such, this article provides a review of some of the genes potentially related to an increased risk for acute myocardial infarction as well as the latest updates in gene-guided risk stratification and treatment strategies.
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Affiliation(s)
- Muzamil Khawaja
- Department of Cardiology, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Rehma Siddiqui
- Department of Internal Medicine, The University of Mississippi Medical Center, Jackson, MS 39216, USA
| | - Salim S Virani
- Department of Cardiology, The Aga Khan University, Karachi 74800, Pakistan
- Department of Cardiology, Baylor College of Medicine, Houston, TX 77030, USA
| | - Christopher I Amos
- Department of Medicine, Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX 77054, USA
| | - Dhrubajyoti Bandyopadhyay
- Department of Cardiology, Westchester Medical Centre, New York Medical College, Valhalla, NY 10595, USA
| | - Hafeez Ul Hassan Virk
- Department of Cardiology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Mahboob Alam
- Department of Cardiology, The Texas Heart Institute, Baylor College of Medicine, Houston, TX 77030, USA
| | - Hani Jneid
- Department of Cardiology, University of Texas Medical Branch, Houston, TX 77030, USA
| | - Chayakrit Krittanawong
- Department of Cardiology, NYU Langone Health and NYU School of Medicine, New York, NY 10016, USA
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Tabaei S, Omraninava M, Mehranfar S, Motallebnezhad M, Tabaee SS. Plasminogen Activator Inhibitor-1 Polymorphisms and Risk of Coronary Artery Disease: Evidence From Meta-Analysis and Trial Sequential Analysis. Biochem Genet 2022; 60:1409-1445. [PMID: 35039979 DOI: 10.1007/s10528-021-10143-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 10/13/2021] [Indexed: 11/29/2022]
Abstract
A systematic review and meta-analysis were conducted to find out if there was association between Plasminogen Activator Inhibitor-1 (PAI-1) gene polymorphisms (- 844 G > A and - 675 4G > 5G) and susceptibility to coronary artery disease (CAD). Search of electronic databases was performed and the pooled odds ratio (OR) and 95% confidence interval (CI) were exerted to evaluate the pooled association between the single-nucleotide polymorphisms (SNPs) and risk of CAD. For - 675 4G > 5G SNP, dominant (OR = 0.90), recessive (OR = 0.90), allelic (OR = 0.91), homozygous (OR = 0.84), and heterozygous (OR = 0.96) models were significantly associated with decreased risk of CAD. Moreover, all five genetic models were associated significantly with decreased CAD risk in the Causation and Arab populations. The results in Asians were marginally significant in recessive, allelic, and homozygote models. The male gender was found to be a risk factor in individuals with PAI-1 4G > 5G SNP in the dominant model (OR = 0.89), recessive model (OR = 0.91), allelic model (OR = 0.92), homozygous model (OR = 0.86), and heterozygous model (OR = 0.91). The results of pooled ORs for overall populations and subgroup analysis by ethnicity reject any association between PAI-1 gene - 844 G > A polymorphism and CAD risk under all genetic comparisons. The results of this meta-analysis indicated that PAI-1 4G > 5G SNP was associated with decreased risk of CAD in the overall population as well as in the Asians, Caucasians, and Arab populations. However, the PAI-1 gene - 844 G > A polymorphism had no significant association with susceptibility to CAD.
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Affiliation(s)
- Samira Tabaei
- Department of Immunology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Melodi Omraninava
- Department of Infectious Disease, Faculty of Medical Sciences, Sari Branch, Islamic Azad University, Sari, Iran
| | - Sahar Mehranfar
- Department of Genetics and Immunology, Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Iran
- Social Determinant of Health Research Center, Clinical Research Institute, Urmia University of Medical Sciences, Urmia, Iran
| | - Morteza Motallebnezhad
- Department of Immunology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Seyedeh Samaneh Tabaee
- Noncommunicable Disease Research Center, Neyshabur University of Medical Sciences, Imam Khomeini Street, 9319116911, Neyshabur, Iran.
- Faculty of Medicine, Neyshabur University of Medical Sciences, Neyshabur, Iran.
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Bayramoglu A, Bayramoglu G, Urhan Kucuk M, Guler HI, Arpaci A. Genetic variations of renin-angiotensin and fibrinolytic systems and susceptibility to coronary artery disease: a population genetics perspective. Minerva Cardiol Angiol 2020; 70:16-24. [PMID: 32989965 DOI: 10.23736/s2724-5683.20.05212-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Genetic predisposition is an important risk factor in coronary artery disease (CAD).This study was conducted to determine the polymorphism frequencies of the plasminogen activator inhibitor-1(PAI-1) gene 4G/5G, angiotensin-converting enzyme (ACE) gene I/D, and angiotensin II type 1 receptor (AT1) gene A1166C genotypes and to examine the role of these polymorphisms in CAD. METHODS Genomic DNAs obtained from 260 subjects (130 CAD patients and 130 control) were used in the study. ACE I/D and PAI-1 4G/5G polymorphism genotypes were determined using polymerase chain reaction (PCR) and electrophoresis. AT-1 A1166C polymorphism was determined using the PCR, restriction fragment length polymorphism (RFLP) and electrophoresis. The products amplified from AT1 gene by PCR were cut with HindIII restriction endonuclease and then analyzed by 2% agarose gel electrophoresis. The results were statistically analyzed with the chi-square test, Mann-Whitney U test, and independent two-sample t-test. RESULTS Allele frequencies showed statistically significant differences between the patient and control groups. There was no statistically significant difference in ACEI/D genotype frequencies between the twogroups. Likewise, no statistically significant difference was found in the AT1 A1166C genotype frequencies; however, a statistically significant difference was found in allele frequencies. The PAI-1 4G/5G genotype frequency was significantly higher in the patient group. CONCLUSIONS While there is a relationship between of PAI-1 gene 4G/5G polymorphism and CAD, ACE gene I/D and AT1 gene A1166C polymorphisms are not related. PAI-1 gene homozygous genotypes may be considered as a prognostic marker for CAD patients.
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Affiliation(s)
- Aysegul Bayramoglu
- Department of Molecular Biology and Genetics, Institute of Science, Artvin Coruh University, Artvin, Turkey - .,Department of Nutrition and Dietetics, Faculty of Health Sciences, Artvin Coruh University, Artvin, Turkey -
| | - Gokhan Bayramoglu
- Department of Molecular Biology and Genetics, Institute of Science, Artvin Coruh University, Artvin, Turkey.,Department of Occupational Health and Safety, Faculty of Health Sciences, Artvin Coruh University, Artvin, Turkey
| | - Meral Urhan Kucuk
- Department of Medical Biology, Faculty of Medicine, Mustafa Kemal University, Antakya, Turkey
| | - Halil I Guler
- Department of Molecular Biology and Genetics, Faculty of Science, Karadeniz Technical University, Trabzon, Turkey
| | - Abdullah Arpaci
- Department of Medical Biochemistry, Faculty of Medicine, Mustafa Kemal University, Antakya, Turkey
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Liu B, Tang Y, Yi M, Liu Q, Xiong H, Hu G, Yuan X. Genetic variants in the plasminogen activator inhibitor-1 gene are associated with an increased risk of radiation pneumonitis in lung cancer patients. Cancer Med 2017; 6:681-688. [PMID: 28211612 PMCID: PMC5345627 DOI: 10.1002/cam4.1011] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Revised: 11/14/2016] [Accepted: 12/18/2016] [Indexed: 12/25/2022] Open
Abstract
Plasminogen activator inhibitor‐1 (PAI‐1) plays a crucial role in the process of lung injury, although its association with radiation pneumonitis (RP) is unclear. We hypothesized that genetic variants in PAI‐1 may influence the risk of RP. In this study, 169 lung cancer patients were genotyped for six single‐nucleotide polymorphisms in PAI‐1 using the Sequenom MassARRAY system. The risk of RP was evaluated by Cox proportional hazards analyses. The cumulative RP probabilities by genotype were assessed using Kaplan–Meier analyses. Univariate and multivariate analyses revealed that PAI‐1:rs7242 GT/GG was correlated with an increased occurrence of grade ≥3 RP (crude hazard ratio = 3.331; 95% confidence interval, 1.168–9.497; P = 0.024). Our results indicated that PAI‐1:rs7242 in the 3′‐untranslated region of PAI‐1 can be a predictor of grade ≥3 RP before radiotherapy.
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Affiliation(s)
- Bo Liu
- Department of Oncology, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Yang Tang
- Department of Oncology, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Minxiao Yi
- Department of Oncology, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Qingxu Liu
- Department of Oncology, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Huihua Xiong
- Department of Oncology, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Guangyuan Hu
- Department of Oncology, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Xianglin Yuan
- Department of Oncology, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
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Karimian A, Farajnia S, Ghojazadeh M, Khaki-Khatibi F. The Association between PAI-1 Gene Promoter Polymorphism and Serum Serpin E1, MDA, and Hs-CRP Levels in Coronary Artery Disease. Int Cardiovasc Res J 2016. [DOI: 10.17795/icrj-10(03)129] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Blood Biomarkers in Minor Stroke and Transient Ischemic Attack. Neurosci Bull 2016; 32:463-8. [PMID: 27250628 DOI: 10.1007/s12264-016-0038-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Accepted: 05/05/2016] [Indexed: 01/11/2023] Open
Abstract
Minor stroke and transient ischemic attack (TIA) are common disorders with a high rate of subsequent disabling stroke, so the early recognition and management of minor stroke and TIA is of great importance. At the moment, the diagnosis of these disorders is based on neurologic deficits in a stroke-clinician's examination of the patient, supplemented by the results of acute brain imaging. However, high variability in TIA diagnosis has been reported between physicians, even trained vascular neurologists, and image-based diagnostic confirmation is not always readily available. Some patients still have ischemic events despite sustained standard secondary preventive therapy. Blood biomarkers are promising to aid in the diagnosis, risk stratification, and individual treatment of minor stroke and TIA. Some studies are being conducted in this field. This mini-review aims to highlight potential biomarkers for diagnosis and those helpful in predicting the risk of future stroke and the selection of treatment.
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Cvetkovic D, Lafaro R, Giamelli J, Suvro S, Erb M, Yaghoubian S. Quadruple Vessel Coronary Artery Bypass Grafting in a 14-Year-Old Child With Plasminogen Activator Inhibitor-1 4G/4G Gene Polymorphism. Semin Cardiothorac Vasc Anesth 2016; 20:163-7. [DOI: 10.1177/1089253216631426] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Myocardial ischemia due to coronary artery disease is an extremely rare condition in childhood and adolescence. Absence of obvious serious risk factors remains a challenge to modern cardiology. We present the case of a 14-year-old boy who underwent quadruple-vessel coronary artery bypass grafting with bilateral pedicled internal mammary artery and bilateral radial artery grafting. We try to highlight a rare but important 4G variant PAI-1 (SERPINE 1) gene mutation as the etiology of severe coronary artery disease in our patient. To the best of our knowledge, he is one of the youngest patients who underwent coronary artery bypass surgery with 4 arterial grafts.
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Affiliation(s)
- Draginja Cvetkovic
- New York Medical College and Westchester Medical Center, Valhalla, NY, USA
| | - Rocco Lafaro
- New York Medical College and Westchester Medical Center, Valhalla, NY, USA
| | - Joseph Giamelli
- New York Medical College and Westchester Medical Center, Valhalla, NY, USA
| | - Sett Suvro
- New York Medical College and Westchester Medical Center, Valhalla, NY, USA
| | - Markus Erb
- New York Medical College and Westchester Medical Center, Valhalla, NY, USA
| | - Saman Yaghoubian
- New York Medical College and Westchester Medical Center, Valhalla, NY, USA
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The Effect of PAI-1 4G/5G Polymorphism and Clinical Factors on Coronary Artery Occlusion in Myocardial Infarction. DISEASE MARKERS 2015; 2015:260101. [PMID: 26273123 PMCID: PMC4529953 DOI: 10.1155/2015/260101] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Accepted: 07/06/2015] [Indexed: 01/16/2023]
Abstract
Objective. Data on the impact of PAI-1-675 4G/5G genotype for fibrinolysis during myocardial infarction are inconsistent. The aim of our study was to evaluate the association of clinical and genetic (PAI-1-675 4G/5G polymorphism) factors with coronary artery occlusion in patients with myocardial infarction. Materials and Methods. PAI-1-675 4G/5G detection was achieved by using Sanger sequencing in a sample of patients hospitalized for stent implantation due to myocardial infarction. We categorized the patients into two groups: patients with coronary artery occlusion and patients without coronary artery occlusion according to angiographic evaluation. Results. We identified n = 122 (32.4%) 4G/4G, n = 186 (49.5%) 4G/5G, and n = 68 (18.1%) 5G/5G PAI-1 genotype carriers. Univariate and multivariate analysis showed that only the 4G/5G genotype was associated with coronary artery occlusion (OR: 1.656 and 95% CI: 1.009–2.718, p = 0.046). Conclusions. Our results showed that carriers of PAI-1 4G/5G genotype with myocardial infarction have increased odds of coronary artery occlusion more than 1.6 times in comparison to the carriers of homozygous genotypes.
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Okafor ON, Gorog DA. Endogenous Fibrinolysis: An Important Mediator of Thrombus Formation and Cardiovascular Risk. J Am Coll Cardiol 2015; 65:1683-1699. [PMID: 25908074 DOI: 10.1016/j.jacc.2015.02.040] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Revised: 02/20/2015] [Accepted: 02/23/2015] [Indexed: 11/15/2022]
Abstract
Most acute cardiovascular events are attributable to arterial thrombosis. Plaque rupture or erosion stimulates platelet activation, aggregation, and thrombosis, whilst simultaneously activating enzymatic processes that mediate endogenous fibrinolysis to physiologically maintain vessel patency. Interplay between these pathways determines clinical outcome. If proaggregatory factors predominate, the thrombus may propagate, leading to vessel occlusion. However, if balanced by a healthy fibrinolytic system, thrombosis may not occur or cause lasting occlusion. Despite abundant evidence for the fibrinolytic system regulating thrombosis, it has been overlooked compared with platelet reactivity, partly due to a lack of techniques to measure it. We evaluate evidence for endogenous fibrinolysis in arterial thrombosis and review techniques to assess it, including biomarkers and global assays, such as thromboelastography and the Global Thrombosis Test. Global assays, simultaneously assessing proaggregatory and fibrinolytic pathways, could play a role in risk stratification and in identifying impaired fibrinolysis as a potential target for pharmacological modulation.
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Affiliation(s)
- Osita N Okafor
- East & North Hertfordshire NHS Trust, Hertfordshire, United Kingdom
| | - Diana A Gorog
- East & North Hertfordshire NHS Trust, Hertfordshire, United Kingdom; Vascular Sciences, National Heart & Lung Institute, Imperial College, London, United Kingdom.
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Senol S, Es MU, Gokmen G, Ercin O, Tuylu BA, Kargun K. Genetic polymorphisms in preoperative myocardial infarction. Asian Cardiovasc Thorac Ann 2015; 23:389-93. [PMID: 25122721 DOI: 10.1177/0218492314547724] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVE This study compared plasminogen activator inhibitor 1 and methylenetetrahydrofolate reductase C677T and A1298C polymorphisms in patients with myocardial infarction with ST-segment elevation before undergoing to coronary artery bypass grafting, and in patients who had previously undergone coronary artery bypass grafting. METHOD Seventy patients with myocardial infarction with ST-segment elevation, scheduled to undergo coronary artery bypass grafting, were included in the study group, and 70 patients who had previously undergone coronary artery bypass grafting were included in the control group. Genetic polymorphisms were determined using real-time polymerase chain reaction methods. RESULTS Our data showed that there were no significant differences in plasminogen activator inhibitor 1 and methylenetetrahydrofolate reductase C677T and A1298C polymorphisms or allele frequencies between the 2 groups. CONCLUSION Plasminogen activator inhibitor 1 and methylenetetrahydrofolate reductase C677T and A1298C polymorphisms were not associated risk factors in patients who had myocardial infarction with ST-segment elevation and planned to have coronary artery bypass grafting.
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Affiliation(s)
- Sefa Senol
- Department of Cardiovascular Surgery, Educational and Research Hospital, Elazig, Turkey
| | - Mehmet Ugur Es
- Department of Cardiovascular Surgery, Rentip Hospital, Bursa, Turkey
| | - Gökhan Gokmen
- Department of Anesthesiology and Reanimation, Rentip Hospital, Bursa, Turkey
| | - Ozlem Ercin
- Department of Cardiology, Educational and Research Hospital, Elazig, Turkey
| | - Berrin Ayaz Tuylu
- Department of Molecular Biology, Anadolu University, Eskisehir, Turkey
| | - Kursat Kargun
- Department of Molecular Biology, Anadolu University, Eskisehir, Turkey
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El-Aziz TAA, Rezk NA. Relation of PAI-1 and TPA Genes Polymorphisms to Acute Myocardial Infarction and its Outcomes in Egyptian Patients. Cell Biochem Biophys 2014; 71:227-34. [DOI: 10.1007/s12013-014-0188-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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Gazi E, Temiz A, Altun B, Barutcu A, Silan F, Colkesen Y, Ozdemir O. Endothelial function and germ-line ACE I/D, eNOS and PAI-1 gene profiles in patients with coronary slow flow in the Canakkale population: multiple thrombophilic gene profiles in coronary slow flow. Cardiovasc J Afr 2014; 25:9-14. [PMID: 24435163 PMCID: PMC3959185 DOI: 10.5830/cvja-2013-083] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2011] [Accepted: 08/14/2013] [Indexed: 11/25/2022] Open
Abstract
Background We examined the effects of ACE, PAI-1 and eNOS gene polymorphisms on endothelial function. The genes are related to atherosclerosis and endothelial dysfunction in coronary slow flow (CSF). Methods Thirty-three patients with angiographically proven CSF and 48 subjects with normal coronary flow were enrolled in this study. Coronary flow patterns were determined by the thrombolysis in myocardial infarction (TIMI) frame count method. Endothelial function was assessed in the brachial artery by endothelium-dependent flow-mediated dilatation (FMD). PAI-1 4G/5G, eNOS T-786C and ACE I/D polymorphisms were determined by polymerase chain reaction (PCR) amplification. Results No difference was found between the groups regarding age, heart rate and blood pressure. Males were more prevalent among patients with CSF than control subjects (58.8 vs 29.8%, p = 0.009). Mean TIMI frame counts were significantly higher in CSF patients (24.2 ± 4.0 vs 13.1 ± 2.5 fpm, p = 0.001). FMD was significantly lower in CSF patients than in the controls (4.9 ± 6.6 vs 7.9 ± 5.6%, p = 0.029). TIMI frame count and FMD were found to be negatively correlated in a correlation analysis (r = –0.269, p = 0.015). PAI-1 4G/5G, eNOS T-786C and ACE I/D polymorphisms were similar in the two groups. Conclusions This study showed that endothelial function was impaired in patients with CSF. PAI-1, ACE and eNOS polymorphisms were not related to CSF in our study population.
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Affiliation(s)
- Emine Gazi
- Department of Cardiology, Faculty of Medicine, Canakkale Onsekiz mart University, Canakkale, Turkey
| | - Ahmet Temiz
- Department of Cardiology, Faculty of Medicine, Canakkale Onsekiz mart University, Canakkale, Turkey
| | - Burak Altun
- Department of Cardiology, Faculty of Medicine, Canakkale Onsekiz mart University, Canakkale, Turkey
| | - Ahmet Barutcu
- Department of Cardiology, Faculty of Medicine, Canakkale Onsekiz mart University, Canakkale, Turkey
| | - Fatma Silan
- Department of Medical Genetics, Faculty of Medicine, Canakkale Onsekiz Mart University, Canakkale, Turkey
| | - Yucel Colkesen
- Department of Cardiology, Faculty of Medicine, Canakkale Onsekiz mart University, Canakkale, Turkey
| | - Ozturk Ozdemir
- Department of Medical Genetics, Faculty of Medicine, Canakkale Onsekiz Mart University, Canakkale, Turkey
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Platelet glycoprotein IIIA PIA2 polymorphism is associated with ST elevation acute myocardial infarction in young Mexican population. J Thromb Thrombolysis 2012; 33:389-96. [PMID: 22466811 DOI: 10.1007/s11239-012-0714-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Platelet membrane glycoprotein IIb/IIIa plays an important role in adhesion and platelet aggregation. Polymorphisms of genes in platelet activation and fibrinolysis have been associated with myocardial infarction (MI), however this has not been confirmed by others, and results are still controversial. The aim of this study was to determine the frequency distribution and association of polymorphism in the platelet glycoprotein GPIIIa PLA/A2 and the possible interaction with the 4G/5G in the plasminogen activator inhibitor genes with ST elevation acute myocardial infarction (STEAMI) in young Mexican subjects. A total of 254 unrelated patients with first STEAMI ≤45 years of age, who were admitted to a cardiovascular intense care unit and 254 healthy controls matched by age and gender were recruited from January 2006 and May 2011. The PIA1/A2 and 4G/5G polymorphism were determined in all participants by a PCR restriction based restriction endonuclease digestion. There was a difference in the PIA2 allele distribution between both groups (P = 0.001). Also, we found an increased percent of 4G allele in the group of patients compared to control group (P = 0.001). There was an increased risk for STEAMI in carries with the allele PIA2 and 4G (OR = 4.3, CI 95 % 1.7-6.5). The modifiable risk factors such: smoking, hypertension, family history of cardiovascular disease, and dyslipidemia were associated with myocardial infarction. This is the first study to evaluate the role of gene polymorphism in both the thrombotic and fibrinolytic pathways in young Mexican individuals with STEAMI and suggest a synergistic effect between PIA2 and 4G allele.
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Gong LL, Peng JH, Han FF, Zhu J, Fang LH, Wang YH, Du GH, Wang HY, Liu LH. Association of tissue plasminogen activator and plasminogen activator inhibitor polymorphism with myocardial infarction: a meta-analysis. Thromb Res 2012; 130:e43-51. [PMID: 22771216 DOI: 10.1016/j.thromres.2012.06.015] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2012] [Revised: 04/02/2012] [Accepted: 06/08/2012] [Indexed: 11/15/2022]
Abstract
INTRODUCTION To investigate whether t-PA Alu repeat insertion/deletion (I/D) and PAI-1 4G/5G genetic variations are associated with the risk of MI. METHODS We conducted a meta-analysis to assess the association between the t-PA I/D and PAI-1 4G/5G polymorphisms and risk of MI. We also performed subgroup analyses based on ethnicity (Caucasian, Asian, and African), gender and age. Forty one eligible studies including 12,461 cases and 14,993 controls were identified to evaluate the impact of PAI-1 4G/5G polymorphism on MI. Seven studies investigated the relationship between t-PA I/D and MI. RESULTS This meta-analysis revealed that the PAI-1 4G allele (4G/4G and 4G/5G genotype) was associated with an increased risk of MI compared with the 5G allele in the overall population (OR=1.094, 95% CI=1.021 - 1.172, p=0.011). The relative risks of MI for 4G/4G genotype was increased when compared to 5G/5G genotype and 5G allele, with odds ratio at 1.157 (95% CI 1.015 - 1.320, p=0.029) and 1.126 (95% CI =1.015 - 1.249, p=0.025). However, the results show that the 4G/5G polymorphism risk for MI was not associated with ethnicity stratification as Caucasian, Asian or African population. No substantial differences in the genotype distributions were observed in the MI group and control group along the lines of gender and age. After multivariable analysis t-PA I/D polymorphism showed no consistent association with MI. CONCLUSIONS This study suggests that the 4G/5G polymorphism of PAI-1 may be a risk factor for MI in overall populations.
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Affiliation(s)
- Li-Li Gong
- Beijing Chao-Yang Hospital affiliated with Beijing Capital Medical University, Beijing, China
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Ringelstein M, Jung A, Berger K, Stoll M, Madlener K, Klötzsch C, Schlachetzki F, Stolz E. Promotor polymorphisms of plasminogen activator inhibitor-1 and other thrombophilic genotypes in cerebral venous thrombosis: a case-control study in adults. J Neurol 2012; 259:2287-92. [DOI: 10.1007/s00415-012-6477-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2012] [Revised: 03/04/2012] [Accepted: 03/05/2012] [Indexed: 01/21/2023]
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Li YY. Plasminogen activator inhibitor-1 4G/5G gene polymorphism and coronary artery disease in the Chinese Han population: a meta-analysis. PLoS One 2012; 7:e33511. [PMID: 22496752 PMCID: PMC3319560 DOI: 10.1371/journal.pone.0033511] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2011] [Accepted: 02/09/2012] [Indexed: 11/30/2022] Open
Abstract
Background The polymorphism of plasminogen activator inhibitor-1 (PAI-1) 4G/5G gene has been indicated to be correlated with coronary artery disease (CAD) susceptibility, but study results are still debatable. Objective and Methods The present meta-analysis was performed to investigate the association between PAI-1 4G/5G gene polymorphism and CAD in the Chinese Han population. A total of 879 CAD patients and 628 controls from eight separate studies were involved. The pooled odds ratio (OR) for the distribution of the 4G allele frequency of PAI-1 4G/5G gene and its corresponding 95% confidence interval (CI) was assessed by the random effect model. Results The distribution of the 4 G allele frequency was 0.61 for the CAD group and 0.51 for the control group. The association between PAI-1 4G/5G gene polymorphism and CAD in the Chinese Han population was significant under an allelic genetic model (OR = 1.70, 95% CI = 1.18 to 2.44, P = 0.004). The heterogeneity test was also significant (P<0.0001). Meta-regression was performed to explore the heterogeneity source. Among the confounding factors, the heterogeneity could be explained by the publication year (P = 0.017), study region (P = 0.014), control group sample size (P = 0.011), total sample size (P = 0.011), and ratio of the case to the control group sample size (RR) (P = 0.019). In a stratified analysis by the total sample size, significantly increased risk was only detected in subgroup 2 under an allelic genetic model (OR = 1.93, 95% CI = 1.09 to 3.35, P = 0.02). Conclusions In the Chinese Han population, PAI-1 4G/5G gene polymorphism was implied to be associated with increased CAD risk. Carriers of the 4G allele of the PAI-1 4G/5G gene might predispose to CAD.
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Affiliation(s)
- Yan-yan Li
- Department of Geriatrics, First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
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Tuttolomondo A, Di Raimondo D, Forte GI, Casuccio A, Vaccarino L, Scola L, Pecoraro R, Serio A, Clemente G, Arnao V, Palmeri M, Misiano G, Lio D, Pinto A, Licata G. Single nucleotide polymorphisms (SNPs) of pro-inflammatory/anti-inflammatory and thrombotic/fibrinolytic genes in patients with acute ischemic stroke in relation to TOAST subtype. Cytokine 2012; 58:398-405. [PMID: 22425140 DOI: 10.1016/j.cyto.2012.02.012] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2011] [Revised: 02/19/2012] [Accepted: 02/20/2012] [Indexed: 10/28/2022]
Abstract
BACKGROUND The genetic basis of complex diseases like ischemic stroke probably consists of several predisposing risk factors, such as genes involved in inflammation and thrombotic pathways. On this basis the aim of our study was to evaluate the role of SNPs (single nucleotide polymorphisms) of some pro-inflammatory/anti-inflammatory and coagulation/fibrinolytic genes in patients with acute ischemic stroke. METHODS The study population consisted of 144 consecutive Caucasian adult patients who were hospitalized in the Internal Medicine Department at the University of Palermo between November 2006 and January 2008, and who met inclusion criteria. The cases were patients admitted with a diagnosis of acute ischemic stroke, and age-matched (± 3 years) control subjects: patients admitted to our Internal Medicine Department for any cause other than acute cardiovascular and cerebrovascular events and for routine checkup examinations. Molecular analysis of alleles at the -308 nucleotide (-308G/A) of TNF-α gene, -1082/-819 haplotypes of IL-10 gene, IL-1RN exon 2 VNR polymorphism, alleles at the -174 nucleotide (-174G/C) of IL-6 gene, PAI-1675 5G/4G polymorphism, alleles at the -7351 nucleotide (-7351C/T) of tPA gene was undertaken in both patient groups. RESULTS We analyzed 96 subjects with acute ischemic stroke and 48 control subjects. We observed a significantly higher frequency of IL-10 1082 AA genotype in stroke patients with a significant risk trend. We also reported a higher frequency in stroke subjects with a significant risk trend of the TPA 7351-CT genotype and of IL-1RN-VNTR 86 bp 2/2 genotype. Moreover, we observed a significant relationship with TOAST subtype only with regard to CC TPA genotype and 1/1 IL-1 VNTR 86 bp and lacunar strokes. CONCLUSIONS Ischemic stroke is a common multifactor disease, which is affected by a number of genetic mutations and environmental factors. Our findings showing a relationship between pro-inflammatory/anti-inflammatory and thrombotic/fibrinolytic genes SNPs and ischemic stroke may contribute to delineate a possible stroke risk profile in subjects with cerebrovascular risk factors.
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Affiliation(s)
- Antonino Tuttolomondo
- Dipartimento Biomedico di Medicina Interna e Specialistica, Università degli Studi di Palermo, Italy.
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Bicakcigil M, Tasan D, Tasdelen N, Mutlu N, Yavuz S. Role of fibrinolytic parameters and plasminogen activator inhibitor 1 (PAI-1) promoter polymorphism on premature atherosclerosis in SLE patients. Lupus 2011; 20:1063-71. [PMID: 21719525 DOI: 10.1177/0961203311404911] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Premature atherosclerosis has been recognized as a major co-morbid condition in systemic lupus erythematosus (SLE). In this study, we aimed to investigate the effect of tPA (tissue plasminogen activator) and PAI-1 (plasminogen activator inhibitor) antigen concentrations and 4G/5G polymorphism of the PAI-1 gene on the development of atherosclerosis in SLE patients. One hundred and six SLE patients, 28 Takayasu arteritis (TA) patients and 98 healthy control subjects (HCs) were studied. PAI-1 and tPA antigen levels were measured by ELISA method. PAI-1 gene polymorphism was determined by using allele-specific PCR method. SLE patients had a significantly higher frequency (22.6%) of plaque (p = 0.01) and higher IMT (p=0.04) compared with HCs respectively. Only age at disease onset was associated with plaque formation in multivariate regression analysis (p = 0.001). Plasma tPA ag levels in SLE patients were significantly higher compared with HCs (p = 0.005) and PAI-1 ag levels were significantly higher compared with TA patients (p = 0.03). There were no significant differences between study groups in both genotype distribution and allele frequencies of PAI-1 gene, but SLE patients with 4G/4G genotype had higher IMT (p = 0.02) calcium scoring (p = 0.006) compared with 4G5G/5G5G genotypes. The present study suggests that measuring fibrinolytic parameters would have little additional benefit beyond traditional and novel risk factors in predicting coronary artery disease (CAD).
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Affiliation(s)
- M Bicakcigil
- Department of Rheumatology, Yeditepe University, Faculty of Medicine, Istanbul, Turkey.
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Cymbron T, Raposo M, Kazachkova N, Bettencourt C, Silva F, Santos C, Dahmani Y, Lourenço P, Ferin R, Pavão ML, Lima M. Cross-sectional study of risk factors for atherosclerosis in the Azorean population. Ann Hum Biol 2011; 38:354-9. [PMID: 21322770 DOI: 10.3109/03014460.2011.553203] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND Atherosclerosis-a major cause of vascular disease, including ischemic heart disease (IHD), is a pathology that has a two-fold higher mortality rate in the Azorean Islands compared to mainland Portugal. AIM This cross-sectional study investigated the role of genetic variation in the prevalence of atherosclerosis in this population. SUBJECTS AND METHODS A total of 305 individuals were characterized for polymorphisms in eight susceptibility genes for atherosclerosis: ACE, PAI1, NOS3, LTA, FGB, ITGB3, PON1 and APOE. Data were analysed with respect to phenotypic characteristics such as blood pressure, lipid profile, life-style risk factors and familial history of myocardial infarction. RESULTS In the total sample, frequencies for hypercholestrolemic, hypertensive and obese individuals were 63.6%, 39.3% and 23.3%, respectively. The genetic profile was similar to that observed in other European populations, namely in mainland Portugal. No over-representation of risk alleles was evidenced in this sample. CONCLUSIONS One has to consider the possibility of an important non-genetic influence on the high cholesterolemia present in the Azorean population. Since diet is the most important life-style risk factor for dyslipidemia, studies aiming to evaluate the dietary characteristics of this population and its impact on serum lipid levels will be of major importance.
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Affiliation(s)
- Teresa Cymbron
- Center of Research in Natural Resources (CIRN), University of the Azores, Ponta Delgada, Portugal.
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Cesari M, Pahor M, Incalzi RA. Plasminogen activator inhibitor-1 (PAI-1): a key factor linking fibrinolysis and age-related subclinical and clinical conditions. Cardiovasc Ther 2010; 28:e72-91. [PMID: 20626406 PMCID: PMC2958211 DOI: 10.1111/j.1755-5922.2010.00171.x] [Citation(s) in RCA: 302] [Impact Index Per Article: 21.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
INTRODUCTION The close relationship existing between aging and thrombosis has growingly been studied in this last decade. The age-related development of a prothrombotic imbalance in the fibrinolysis homeostasis has been hypothesized as the basis of this increased cardiovascular and cerebrovascular risk. Fibrinolysis is the result of the interactions among multiple plasminogen activators and inhibitors constituting the enzymatic cascade, and ultimately leading to the degradation of fibrin. The plasminogen activator system plays a key role in a wide range of physiological and pathological processes. METHODS Narrative review. RESULTS Plasminogen activator inhibitor-1 (PAI-1) is a member of the superfamily of serine-protease inhibitors (or serpins), and the principal inhibitor of both the tissue-type and the urokinase-type plasminogen activator, the two plasminogen activators able to activate plasminogen. Current evidence describing the central role played by PAI-1 in a number of age-related subclinical (i.e., inflammation, atherosclerosis, insulin resistance) and clinical (i.e., obesity, comorbidities, Werner syndrome) conditions is presented. CONCLUSIONS Despite some controversial and unclear issues, PAI-1 represents an extremely promising marker that may become a biological parameter to be progressively considered in the prognostic evaluation, in the disease monitoring, and as treatment target of age-related conditions in the future.
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Affiliation(s)
- Matteo Cesari
- Area di Geriatria, Università Campus Bio-Medico, Rome, Italy.
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Prognostic value of plasma fibrinolysis activation markers in cardiovascular disease. J Am Coll Cardiol 2010; 55:2701-9. [PMID: 20538163 DOI: 10.1016/j.jacc.2009.11.095] [Citation(s) in RCA: 83] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2009] [Revised: 10/26/2009] [Accepted: 11/02/2009] [Indexed: 11/24/2022]
Abstract
The pivotal role of hypoactive endogenous fibrinolysis in the occurrence of thrombotic cardiovascular events is now well-recognized. To evaluate the diagnostic and prognostic role of impaired fibrinolysis, plasma fibrinolysis markers have been investigated in large prospective studies in both healthy individuals and patients with established coronary disease. Antigen and activity levels of components of the fibrinolytic system were measured by immunoassays, which replaced earlier global fibrinolysis tests. This review covers 45 studies in nearly 50,000 subjects, examining the association between plasma markers of fibrinolysis and coronary artery disease, to establish the usefulness of these markers in predicting future cardiovascular events. The predictive value of plasma levels of tissue-type plasminogen activator, platelet activator inhibitor-1, plasmin-antiplasmin complex, D-dimer, thrombin activatable fibrinolysis inhibitor, and lipoprotein(a) for major adverse cardiac events is highly variable and conflicting, especially after adjusting for conventional risk factors, judging from the published data in the last decade. The value of fibrinolysis activity markers is very limited in aiding diagnosis and risk stratification in the individual patient, on the basis of the weak prognostic values obtained in some studies and the lack of power in others. The physiological limitations of such markers in reflecting endogenous fibrinolysis is discussed. The emerging novel global assays of fibrinolysis will require large-scale clinical trials before their prognostic power or superiority to multiple biomarker measurements can be evaluated.
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Rallidis LS, Gialeraki A, Merkouri E, Liakos G, Dagres N, Sionis D, Travlou A, Lekakis J, Kremastinos DT. Reduced carriership of 4G allele of plasminogen activator inhibitor-1 4G/5G polymorphism in very young survivors of myocardial infarction. J Thromb Thrombolysis 2009; 29:497-502. [DOI: 10.1007/s11239-009-0398-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Tàssies D, Roqué M, Monteagudo J, Martorell T, Sionis A, Arzamendi D, Heras M, Reverter JC. Thrombin-activatable fibrinolysis inhibitor genetic polymorphisms as markers of the type of acute coronary syndrome. Thromb Res 2009; 124:614-8. [PMID: 19699511 DOI: 10.1016/j.thromres.2009.07.004] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2009] [Revised: 07/01/2009] [Accepted: 07/06/2009] [Indexed: 11/30/2022]
Abstract
INTRODUCTION In patients with coronary disease at risk of acute coronary events it is unclear which biological factors could predict the type of acute coronary syndrome clinical presentation. The aim of the study was to investigate the role of genetic polymorphisms in key proteins in fibrinolysis in the type of acute coronary syndrome. MATERIALS AND METHODS 248 patients with acute coronary syndrome (unstable angina or myocardial infarction) (77% male, mean age 60.75 SD 13.30years) were prospectively recruited. PAI-1 (type-1 plasminogen activator inhibitor) 4G/5G and TAFI (thrombin-activatable fibrinolysis inhibitor) Ala147Thr, C+1542G, and Thr325Ile polymorphisms were determined by PCR. RESULTS 147 (59.3%) patients presented with ST-segment elevation acute coronary syndrome (all Q-wave myocardial infarction), and 101 (40.7%) with non-ST-elevation acute coronary syndrome (52 non-Q wave myocardial infarction, and 49 unstable angina). Homozygous TAFI +1542G and TAFI 325Ile genotypes were less prevalent in patients with ST elevation acute coronary syndrome (p<0.001, OR: 0.22, 95% CI 0.10-0.50 and p<0.001, OR: 0.25, 95% CI 0.11-0.55, respectively). There were no differences in TAFI Ala147Thr or PAI genotype distribution between ST elevation and non-ST elevation acute coronary syndrome. In the multivariate analysis including clinical variables, the best model for ST elevation acute coronary syndrome included TAFI +1542GG (p<0.001, OR: 0.17, 95% CI 0.07-0.30), age (in years, p<0.005, OR: 0.97, 95% CI 0.94-0.98) and dyslipidemia (p<0.005, OR: 2.33, 95% CI 1.42-3.80). CONCLUSION TAFI polymorphism C+1542G and Thr325/Ile are related to the type of acute coronary syndrome. Patients with coronary disease would benefit from individualized cardiovascular prophylaxis based on genetic risk.
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Affiliation(s)
- Dolors Tàssies
- Hemotherapy and Hemostasis Department, Hospital Clínic, Villarroel 170. 08036 Barcelona, Spain.
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Roy H, Bhardwaj S, Yla-Herttuala S. Molecular genetics of atherosclerosis. Hum Genet 2009; 125:467-91. [DOI: 10.1007/s00439-009-0654-5] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2008] [Accepted: 03/04/2009] [Indexed: 12/17/2022]
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