The role of genetics in coronary artery bypass surgery patients under 30 years of age

Abstract

SummaryAim:We undertook genetic assessment of coronary artery disease (CAD) in 20 patients aged 30 years or less undergoing coronary artery bypass grafting (CABG) surgery, to investigate the prognostic value of pre-defined genes.Methods:Twenty patients, who underwent CABG surgery between December 2001 and May 2013, were retrospectively analysed to find out the role their genetic make-up played in their disease. We used three genetic diagnostic tests, the plasminogen activator inhibitor (PAI)-1 gene, the A1/A2 polymorphism of glycoprotein IIIa (GpIIIa) gene, and common polymorphisms of the methylenetetrahydrofolate reductase (MTHFR) gene.Results:The mean age of patients was 26.35 ± 3.51 (19–30) years, and 90% were male (n = 18). One patient had diabetes, three had hypertension, 11 (55%) had dyslipidaemia and 16 (80%) were smokers. Eight of the patients (40%) had left ventricular ejection fraction (LVEF) < 50%, and functional capacity was poor in only two (10%) patients (NYHA III– IV). Follow up was completed in all patients (100%). We found five homozygous and 11 heterozygous mutations in the MTHFR gene, which predisposes individuals to coronary artery disease or deep-vein thrombosis. Eight patients were found to have a GpIIIa gene polymorphism, which is associated with increased risk of myocardial infarction (MI). Fifteen patients had a polymorphism in the promoter region of the PAI-1 gene, which is a major inhibitor of the fibrinolytic system.Conclusion:MTHFR C677T polymorphism, and GpIIIa and PAI-1 genes are risk factors for CAD. In young patients, genetic studies promise to revolutionise early diagnosis, treatment and prevention of CAD and MI.

Correlations of High-frequency Ultrasound Evaluation of Brachial Artery Endothelial Dilatation and Carotid Atherosclerosis with Glucose and Lipid Metabolism, Inflammatory Cytokines, Severity of Coronary Artery Disease and Vascular Endothelial Function in Elderly Patients

“…As a commonly used marker of inflammatory responses in clinical practice, CRP can directly reflect the inflammatory state and stability of atherosclerotic plaques in patients, and it has a certain predictive value for the patient's prognosis (19). PAI-1 is an inflammatory factor of single-chain glycoproteins mainly derived from vascular endothelial cells, which has a close relationship to the insulin signal transduction and can reflect vascular endothelial dysfunction to some extent (20). The results of this study demonstrated that the levels of CRP and PAI-1 in serum were obviously increased in patients with severe CAD.…”

The Prognostic Value of Combinations of Genetic Polymorphisms in the ITGB3, ITGA2, and CYP2C19*2 Genes in Predicting Cardiovascular Outcomes After Coronary Bypass Grafting

“…Genetic research has carefully considered the association of the above-mentioned receptors' gene polymorphisms with acute coronary syndrome, other cardiovascular diseases, and atherothrombogenic outcomes (Cavallari et al, 2007;Maguire et al, 2008;Hoppmann et al, 2014;Moon et al, 2017). However, there is less evidence concerning the association of platelet receptors' single nucleotide polymorphisms (SNPs) with ischemic outcomes after coronary artery bypass grafting (CABG) (Muslimova et al, 2017;Sarikaya et al, 2017).…”