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CLINICAL RESEARCH: MYOCARDIAL INFARCTION

Genetic Polymorphisms of Platelet Glycoprotein Ia and the Risk for Premature Myocardial Infarction

Effects on the Release of sCD40L During the Acute Phase of Premature Myocardial Infarction

Athens University Medical School, 1st Cardiology Department, Hippokration Hospital, Athens, Greece.

Manuscript received September 20, 2005; revised manuscript received November 28, 2005, accepted December 5, 2005.

^_* Reprint requests and correspondence: Dr. Dimitris Tousoulis, S Karagiorga 69, Glifada, Athens, Greece. (Email: tousouli{at}med.uoa.gr).

OBJECTIVES: The aim of this research was to evaluate the effect of genetic polymorphisms C807T and G1648A of platelet glycoprotein Ia (GPIa), on the risk for myocardial infarction (MI) and on the release of soluble CD40 ligand (sCD40L) during the acute phase of MI and one year after the event.

BACKGROUND: C807T and G1648A polymorphisms affect the density of GPIa on platelet surface, but their effect on the risk for MI and the release of sCD40L is unknown.

METHODS: The study population consisted of 219 patients with premature MI and 389 controls. One year after the event, 67 patients and 232 controls were recalled for the follow-up study.

RESULTS: The risk for MI in 807TT was 2.296 (95% confidence interval [CI]: 1.187 to 4.440) p < 0.05 versus CC + CT, 2.269 (95% CI: 1.085 to 4.745) p < 0.05 versus CC, and 2.135 (95% CI: 1.080 to 4.219) p < 0.05 versus CT. During the acute phase of MI, sCD40L was higher in 807CT + TT compared with 807CC (p < 0.01), an effect persisting after one year (p < 0.01). The carriage of 807T allele was an independent predictor for sCD40L during the acute phase of MI (ß = 9.442 [standard error (SE): 2.526], p = 0.001) and in the same patients one year later (ß = 8.282 [SE: 2.044], p = 0.001). In healthy individuals, 807T allele was associated with higher sCD40L levels compared with 807CC (p < 0.05), only among those with von Willebrand factor greater than or equal to median.

CONCLUSIONS: Genetic polymorphism C807T increases the risk for premature MI. 807T allele is an independent predictor for sCD40L levels during the acute phase of premature MI as well as one year after the event, while it is associated with elevated sCD40L levels in healthy subjects, only in the presence of high von Willebrand levels.

Abbreviations and Acronyms   CABG = coronary artery bypass grafting   CI = confidence interval   GPIa = glycoprotein Ia   GPVI = glycoprotein VI   HDL = high-density lipoprotein   MI = myocardial infarction   PCI = percutaneous coronary intervention   sCD40L = soluble CD40 ligand   STEMI = ST-segment elevated myocardial infarction   vWF = von Willebrand factor

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