Prothrombotic genetic risk factors in young survivors of myocardial infarction

作     者：Ardissino, D Mannucci, PM Merlini, PA Duca, F Fetiveau, R Tagliabue, L Tubaro, M Galvani, M Ottani, F Ferrario, M Corral, J Margaglione, M 

作者机构：Univ Milan A Bianchi Bonomi Hemophilia & Thrombosis Ctr I-20122 Milan Italy Policlin San Matteo IRCCS Div Cardiol Pavia Italy Univ Milan Maggiore Hosp IRCCS Dept Internal Med I-20122 Milan Italy Niguarda Hosp Ca Granda Milan Italy San Camillo Hosp Rome Italy Gian Battista Morgagni Hosp Forli Italy Bentivoglio Hosp Bentivoglio Italy Reg Transfus Ctr Murcia Spain Casa Sollievo della Sofferenza IRCCS San Giovanni Rotondo Italy 

出 版 物：《BLOOD》 (血液)

年 卷 期：1999年第94卷第1期

页      面：46-51页

核心收录：

学科分类：1002[医学-临床医学] 1001[医学-基础医学(可授医学、理学学位)] 10[医学] 

主　　题：等位基因 抗原 CD/遗传学 病例对照研究 因子Ⅴ/遗传学 因子Ⅶ/遗传学 整合素β3 亚甲基四氢叶酸还原酶(NADPH) 心肌梗死/病因学 心肌梗死/遗传学 作用于CH-NH族供体的氧化还原酶类/遗传学 纤溶酶原激活物抑制物1/遗传学 血小板糖蛋白GPⅠb-Ⅸ复合物/遗传学 血小板膜糖蛋白类/遗传学 多态现象 遗传 凝血酶原/遗传学 危险因素 血栓形成/病因学 血栓形成/遗传学 成年人 女(雌)性 人类 男(雄)性 

摘      要：It has long been thought that an individual thrombotic tendency increases the risk of myocardial infarction, especially in young adults. Several prothrombotic genetic factors that may influence the individual thrombotic risk have been identified. To investigate the association between the risk of myocardial infarction at a young age and genetic factors thought to be associated with an increased tendency to thrombosis (the polymorphisms 4G/5G of the PAI-1 gene, PIA1/PIA2 of the platelet glycoprotein IIIa, C3550T of the platelet glycoprotein Ib gene, G10976A of the factor VII gene, C677T of the methylenetetrahydrofolate reductase gene, G1691A of the factor V gene, and G20210A of the prothrombin gene), we performed a case-control study evaluating 200 survivors (185 men, 15 women) of myocardial infarction who had experienced the event before the age of 45 years and 200 healthy subjects with a negative exercise test, individually matched for sex, age, and geographic origin with the cases. The presence of the PIA2 polymorphic allele was the only prothrombotic genetic factor associated with the risk of myocardial infarction at a young age. The odds ratio for carriers of the PIA2 allele compared with those of the PIA1 allele was 1.84 (95% confidence intervals (CI) 1.12 to 3.03). There was a significant interaction between the presence of the PIA2 allele and smoking: with their simultaneous presence, 46% (95% confidence intervals 11% to 81%) of premature myocardial infarctions were attributable to the interaction between the two factors. In conclusion, carrying the PIA2 polymorphic allele of platelet glycoprotein IIIa was the only genetic prothrombotic factor associated with the risk of developing myocardial infarction at a young age. The clinical expression of this genetic predisposition seems to be enhanced by smoking. (C) 1999 by The American Society of Hematology.