Vol 64, No 12 (2006)
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Published online: 2006-12-21

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Original article
The effect of glycoprotein IIIa A1/A2 gene polymorphism on one-year outcome in patients with ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention

Anna Kozieradzka, Karol Kamiński, Witold Pepiński, Jerzy Janica, Janusz Korecki, Konrad Skolimowski, Emilia Frankowska, Paweł Kralisz, Tomasz A. Bonda, Sławomir Dobrzycki, Włodzimierz Jerzy Musiał
DOI: 10.33963/v.kp.81387
Kardiol Pol 2006;64(12):1350-1355.

Abstract

Introduction: Glycoprotein IIb/IIIa (GP IIb/IIIa) is a platelet receptor composed of two subunits coded by individual genes. GP IIIa gene has two alleles: A1 and A2. The A2 allele determines higher platelet activity and was investigated many times as a potential risk factor of ACS. The influence of A1/A2 polymorphism on the prognosis in patients with ST-segment elevation myocardial infarction (STEMI) has not been analysed so far. Aim: Evaluation of the relationship between GP IIb/IIIa A1/A2 gene polymorphism and one-year prognosis in patients with STEMI treated with primary percutaneous coronary intervention (pPCI). Methods: 171 patients (23.9% – women, 39.7% – anterior MI) with STEMI treated successfully with pPCI as well as 121 healthy subjects from a reference group were enrolled in the study. Genotyping was performed using restriction fragment length polymorphism analysis (RFLP). In one-year follow-up the primary end point included deaths and infarctions. The following methods were used in statistical analysis: c2 as well as Mann-Whitney test, Kaplan-Meier survival analysis, Cox regression model and multivariate analysis. Results: The percentage of A2 allele carriers was similar in STEMI patients and in subjects from the reference group (27.4% vs. 21.5%, p=0.24). No statistically significant difference in the incidence of primary end point between the A1A1 homozygotes and A2 allele carriers (A1A2/A2A2 genotype) was observed among STEMI patients. In Cox regression analysis, the variables associated with death or MI were: ejection fraction (RR 0.912, p=0.01) and systolic blood pressure on admission (RR 0.97, p=0.049). The variables categorised as unfavourable predictors included: Killip class >2 and heart ratio on admission >100/min (p <0.05, log-rank test). Conclusion: No relationship between GP IIb/IIIa A1/A2 gene polymorphism and STEMI incidence as well as one-year prognosis in patients with STEMI treated with pPCI was documented.

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Polish Heart Journal (Kardiologia Polska)