Association of Hemostatic Gene Polymorphisms With Early-Onset Ischemic Heart Disease in Egyptian Patients

Abstract

The association between hereditary thrombophilia and venous thrombosis is well established but controversial data exist with respect to arterial thrombosis. We performed a pilot study on 31 patients with acute myocardial infarction (AMI), 21 patients with unstable angina (UA), and 20 healthy volunteers to investigate the role of various hemostatic gene polymorphisms in young Egyptian patients, who survived their first ischemic heart disease (IHD). Thrombophilic gene polymorphisms were tested using multiplex polymerase chain reaction and reverse-hybridization technique. We showed an increased risk of AMI with factor V (FV) Leiden and prothrombin G20210A heterozygosity. The increased risks of UA was associated with GA and A allele of fibrinogen β-455G→A polymorphism. Conversely, factor XIII (FXIII) Val34Leu GT and T allele were protective in the UA group. Nevertheless, the prevalence of FV H1299R, plasminogen activator inhibitor 1 4G/5G, glycoprotein IIIa C1565T, 5,10-methylenetetrahydrofolate reductase C677T, and A1298C mutations did not differ between patients with IHD and controls. The data have clinical implications regarding screening and thromboprophylaxis in high-risk individuals younger than 40 years.

Increased coagulation factor XIII activity but not genetic variants of coagulation factors is associated with myocardial infarction in young patients

“…On the other hand, the F13A1 Val34Leu GT (CA) genotype and T (A) allele were shown to have a protective effect in the unstable angina group of very young patients aged < 40 years but not in MI patients [20]. Nevertheless, the F13A1 gene T variant was also associated with arterial ischemic stroke in children, particularly in combination with several coagulation factor gene variants [21].…”

Acute myocardial infarction,arterial thrombosis and thrombophilia in young patients

“…Напоследък особен интерес за кардиолозите представляват младите пациенти, представящи се с ОМИ. Към този момент не съществува точно определение за "млад" и възрастовата граница варира от ≤ 30 до ≤ 55 [11,12,21,22,29]. Независимо от това, че ОМИ е рядка диагноза в тези възрастови групи, ранната диагностика и лечението са изключително важни фактори, ограничаващи заболяемостта, психологичните ефекти и финансовите аспекти в живота на пациента и неговото семейство.…”

“…[4] Recently a peculiar interest for cardiologists is focused on young patients with AMI. There is no universal defi nition for "young" and the age cut-off varies from ≤ 30 to ≤ 55 [11,12,21,22,29]. Although AMI is rare in this group of patients, the early diagnosing and treatment is essential to limit the morbidity, psychological eff ects and fi nancial constraints for the person and its family.…”

“…Египетско проучване [29] проследява асоциацията между хемостазния генен полиморфизъм и ранното начало на ИБС преди 40-годишна възраст, включително ОМИ (31 пациенти). Alkhiary и сътр.…”

“…An Egyptian study [29] explores association of haemostatic gene polymorphisms with early-onset IHD before the age of 40 years, including AMI (31 patients). Thus Alkhiary et al consist that factor V Leiden and prothrombin G20210A heterozygosity increase the risk установяват, че мутации на фактор V Лайден и хетерозиготно носителство на протромбин G20210A с увеличават риска от ОМИ.…”