Genetic polymorphisms in early-onset myocardial infarction in a sample of Iraqi patients: a pilot study

Abstract

Objectives Early-onset myocardial infarction constitutes nearly one third of cases of myocardial infarction among Iraqis, which is rather higher than the proportions reported in many Western countries. Thus this study was initiated to investigate the role of some genetic polymorphisms, as well as acquired risk factors in this condition. Results A total of 102 Iraqi patients with first myocardial infarction aged 50 years, and 77 matched controls were enrolled. The DNAs of participants were screened for nine polymorphisms, namely: β-Fibrinogen (− 455G > A), Factor XIII (V34L), Plasminogen Activator inhibitor-1 (PAI-1, 4G/5G), Human Platelet Antigen-1 (HPA1a/b), 5,10-Methylenetetrahydrofolate Reductase MTHFR (C677T) and MTHFR (A1298C), Angiotensin-Converting Enzyme (ACE) 287 bp insertion/deletion (I/D), Apolipoprotein-B (ApoB: R3500Q), and Apolipoprotein-E (Apo E: E2/E3/E4), using PCR and reverse hybridization technique. Among traditional risk factors, univariate analysis revealed that smoking (OR 2.86 [95%CI 1.53–5.34]), hyperlipidemia (OR 5.23 [95%CI 2.66–10.29]), and diabetes mellitus (OR 4.05 [95% CI 1.57–10.41]) were significantly higher among patients compared to controls (P<0.001, <0.001 and 0.002 respectively), while none of the nine genetic polymorphisms reached significance. Multivariate Logistic regression, however, revealed that only smoking and hyperlipidemia retained significance (P of < 0.001 each). The need to initiate further studies on larger cohorts is paramount to understand the higher than expected frequency of early-onset myocardial infarction in our population.

Outcomes of primary percutaneous coronary intervention in ST-Segment elevation myocardial infarction in Kurdistan Region of Iraq

“…Almost 30% of cases of STEMI in this study were among young. 5 Another striking point is the predominate male gender affection by the disease in the current study. The potential explanation of this phenomena is that the males constitute the bulk of the young premature CAD and the second is the wellknown protective effect of estrogen in premenopausal age in females.…”

“…It is recognizable that the traditional risk is more important the genetic polymorphisms in this group of patients according to available data from the area. 5,8 The fast majority of our cases were presented for first time with CAD with negative past history of coronary disease. Only one fifth of cases had past history of CAD regardless of the original presentation.…”

Coagulation Factor XIII Val34Leu Polymorphism in the Prediction of Premature Cardiovascular Events—The Results of Two Meta-Analyses

“…Finally, 18 case–control studies on young adults analysing FXIII polymorphism with regards to IS and MI met the inclusion criteria (3222 cases and 5894 controls in total), including 6 studies on IS (627 cases with stroke and 1639 controls [ 9 , 11 , 12 , 26 , 27 , 28 ]) and 13 studies on MI (2595 cases with premature MI and 4255 controls [ 10 , 12 , 13 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 ]). In the study by Reiner et al [ 12 ], subgroups of patients with both IS and MI were analysed.…”

“… Forest plots for relations between different genetic models of FXIII polymorphism and myocardial infarction in total groups of young patients: ( A ) Val/Leu + Leu/Leu vs. Val/Val; ( B ) Leu/Leu vs. Val/Leu + Val/Val; ( C ) Leu/Leu vs. Val/Val; ( D ) Val/Leu vs. Val/Val; ( E ) Leu vs. Val. M-H: Mantel–Haenszel; CI: confidence interval; I 2 : heterogeneity; df: degrees of freedom [ 10 , 12 , 13 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 ]. …”

Clinico-angiographic profiles and in-hospital outcomes of non-ST segment elevation myocardial infarction in Kurdistan Region of Iraq

“…4 This is believed to be due to many reasons, including the ageing of the population with a greater prevalence of diabetes and chronic kidney disease; and extensive use of troponin assays with higher sensitivity for myocardial injury, which move the diagnosis from unstable angina to NSTEMI. [5][6][7] The risk stratification for cases with NSTEMI can be obtained from several prognostic scores like the TIMI (Thrombolysis in Myocardial Infarction) and GRACE (Global Registry of Acute Coronary Events) scores. 8,9 TIMI and GRACE scores can be determined from the patient's clinical characteristics, electrocardiographic and laboratory investigations performed on admission.…”