Atherosclerotic and thrombotic genetic and environmental determinants in Egyptian coronary artery disease patients: a pilot study

Abstract

BackgroundCoronary artery disease (CAD) is the leading cause of morbidity and mortality worldwide. Multiple genetic variants in combination with various environmental risk factors have been implicated. This study aimed to investigate the association of twelve thrombotic and atherosclerotic gene variants in combination with other environmental risk factors with CAD risk in a preliminary sample of Egyptian CAD patients.MethodsTwenty three consecutive CAD patients undergoing diagnostic coronary angiography and 34 unrelated controls, have been enrolled in the study. Genotyping was based on polymerase chain reaction and reverse multiplex hybridization. Five genetic association models were tested. Data distribution and variance homogeneity have been checked by Shapiro-Wilk test and Levene test, respectively; then the appropriate comparison test was applied. Spearman’s rank correlation coefficient was used for correlation analysis and logistic regression has been performed to adjust for significant risk factors. Clustering the study participants according to gene-gene and gene-environment interaction has been done by Detrended Correspondence Analysis (DCA).ResultsThe univariate analysis indicated that the five variants; rs1800595 (FVR2; factor 5), rs1801133 (MTHFR; 5,10-methylenetetrahydrofolate reductase), rs5918 (HPA-1; human platelet antigen 1), rs1799752 (ACE; angiotensin-converting enzyme), and rs7412 and rs429358 (ApoE; apolipoprotein E) were significantly associated with CAD susceptibility under different genetic models. Multivariate analysis revealed clustering of the study population into three patient groups (P) and one control group. FVR2 was the most variant associated with CAD patients, combined with the factor V Leiden (FVL) variant in P1 cluster and with both ACE and MTHFR 667C > T in P2. Whereas, P3 was mostly affected by both MTHFR 667C > T and FXIII (factor 13) V89L mutations. When combined with traditional risk factors, P1 was mostly affected by dyslipidemia, smoking and hypertension, while P2 was mostly affected by their fasting blood sugar levels and ApoE variant.ConclusionsTaken together, these preliminary results could have predictive value to be applied in refining a risk profile for our CAD patients, in order to implement early preventive interventions including specific antithrombotic therapy. Further large scale and follow-up studies are highly recommended to confirm the study findings.Electronic supplementary materialThe online version of this article (doi:10.1186/s12872-016-0456-3) contains supplementary material, which is available to authorized users.

Management of pharmacotherapy‐related problems in acute coronary syndrome: Role of clinical pharmacist in cardiac rehabilitation unit

“…Coronary artery disease remains a leading cause of morbidity and mortality in most regions worldwide …”

“…In Egypt, cardiovascular diseases were responsible for 21% of deaths in 2013 with a prevalence of 8.3% . Acute coronary syndrome (ACS) also results in productivity losses, significant healthcare costs and impairment in quality of life …”

“…Coronary artery disease remains a leading cause of morbidity and mortality in most regions worldwide. 1,2 Coronary artery diseases are estimated to cause approximately 13% of total deaths worldwide according to the World Health Organization in 2014. 3 About 80% of deaths from cardiovascular diseases occur in low-income and middle-income countries.…”

“…4 In Egypt, cardiovascular diseases were responsible for 21% of deaths in 2013 with a prevalence of 8.3%. 2 Acute coronary syndrome (ACS) also results in productivity losses, significant healthcare costs and impairment in quality of life. 5 Despite the fact that secondary prevention strategy can prevent up to 45% of deaths after a myocardial infarction, 6 adherence to secondary prevention measures after hospital discharge for acute coronary syndrome (ACS) has been found to be poor.…”

Clinical Significance of Platelet Antigen 1/Platelet Antigen 2 (PlA1/A2) Polymorphism of Integrin b3 (ITGB3) Gene in Coronary Artery Disease

“…CORONARY Artery Disease (CAD) remains a leading cause of death worldwide despite of the scientific advancements in the understanding of its pathophysiology [1] . In Egypt, CAD is responsible for 21% of all deaths and its prevalence rate is 8.3% [2] . It is a multifactorial complex chronic inflammatory disease where atherosclerosis and its superimposed thrombosis result in the occlusion of the coronary arteries and the occurrence of CAD [3] .…”