Prediction of long-term outcomes in patient with myocardial infarction using locus 9p21.3 risk genotypes

Abstract

Target. To study the relationship of single nucleotide polymorphism (SNP) rs1333049 locus 9p21.3 with individual outcomes of patients with myocardial infarction (MI). Materials. The study included 500 patients with MI aged ≤65 years (53.35 ± 7.79 years), 411 (82.2%) men and 89 (17.8%) women. Genotyping of SNP rs1333049 of the 9p21.3 locus was performed using real-time polymerase chain reaction (PCR) in accordance with the manufacturer's protocol (TaqMan zones, Applied Biosystem 7900HT). All patients discharged from the hospital were divided into 2 groups: 1 - patients who underwent PCI, 2 - patients who received conservative therapy, including thrombolytic therapy. The prospective observation period was 2 years. Methods. Biochemical tests - indicators of lipid profile, CRP, were assessed at baseline, after 1.2 and 6 months. Echocardiographic examination and Doppler ultrasound examination of TCIM of the carotid arteries were performed before and after 6 months of treatment. Results. An association of SNP rs1333049 of the 9p21 locus with the outcomes of myocardial infarction (repeated MI, acute coronary syndrome - ACS, repeated PCI) in the long-term follow-up period (6,12,24 months) in patients with MI who did not undergo PCI in the hospital (group 2) was found. During the first year after discharge from the hospital, carriers of the C risk allele rs1333049 had a higher risk of recurrent MI (RR 1.13; 95% CI 1.07-1.19), ACS (RR 1.32; 95% CI 1, 15-1.51), repeat PCI (RR 1.23; 95% CI 1.10-1.37). After 2 years of follow-up, there was a higher risk of recurrent MI (RR 1.26; 95% CI 1.12-1.63) and ACS (RR 1.46; 95% CI 1.21-1.78). Conclusion. Genetic markers can be used to stratify the risk of patients with myocardial infarction and determine the measures of secondary prevention after the discharge of a patient with myocardial infarction from the hospital.