Impact of gene polymorphisms on long-term prognosis in patients with myocardial infarction

Aim

To evaluate the prognostic value of gene polymorphisms ACE (D/I), SLCO1B1 (Val174Ala), LIPC (C514T), CYP2C19*2, CYP2C19*3, ADRB1 (Ser49Gly), ADRB1 (Arg389Gly) in patients with ST-segment elevation myocardial infarction (STEMI).

Material and methods

155 patients from 45 to 75 years of age with STEMI were enrolled in the prospective study. All patients were treated with recommended preparations improving prognosis (statins, angiotensin-converting enzyme inhibitors, beta-blockers, clopidogrel as part of dual antiplatelet therapy) from the first day of hospitalization. A primary endpoint included cardiovascular death, nonfatal myocardial infarction, unplanned revascularization of coronary arteries and hospitalization for unstable angina within 12 months.

Results

The II genotype of the polymorphic gene ACE (I/D) is an independent predictor of the favorable outcome of STEMI. Allele Ser of the polymorphic gene ADRB1 Ser49Glyis associated with an increased incidence of adverse cardiovascular events within 12 months after STEMI. Gene polymorphisms SLCO1B1 (Val174Ala), CYP2C19*2, CYP2C19*3, ADRB1 (Arg389Gly), LIPC (C514T) do not affect a 12-month prognosis after STEMI.

Conclusion

Genotyping of ACE (I/D) and ADRB1 Ser49Gly can be used to predict long-term prognosis and effectiveness of pharmacotherapy STEMIt.

Key words

Gene polymorphism, pharmacogenetics, prognosis, myocardial infarction.