НЕКОТОРЫЕ ГЕНЕТИЧЕСКИЕ МАРКЕРЫ РИСКА ПОСТИНФАРКТНОЙ СЕРДЕЧНОЙ НЕДОСТАТОЧНОСТИ

Abstract

Вackground. Postinfarction heart failure is a serious complication of myocardial infarction requiring personalized early diagnosis, and in particular, using molecular genetic markers. Purpose of the study. To determine the role of different genotype variants according to polymorphic variants: rs5186 of angiotensin II receptor A1166 C type 1 gene and rs5068 of atrial natriuretic peptide gene in the development of chronic heart failure in postinfarction period. Patient Characterization and Research Methods. An open prospective non-randomized cohort study by parallel-group method included 186 patients (mean age 63.5 years) who underwent myocardial infarction from January 2019 to January 2020 and were treated at the regional vascular center No 1 of City Clinical Hospital No 1 of Novosibirsk. Novosibirsk. The study group consisted of 86 people with signs of CHF above the 2nd class (NYHA) and the comparison group consisted of 100 people without signs of CHF or with CHF of the 1st class (NYHA). The diagnosis of MI and CHF was made according to national and European guidelines [1, 2]. Both groups received standard therapy for these pathologies. Clinical outcomes were assessed 1 year after discharge: cardiovascular mortality, repeated hospitalizations due to CHF decompensation, death from other causes, stroke, recurrent myocardial infarction, unscheduled coronary revascularization. Methods of statistical analysis. Statistical analysis was performed with the help of SPSS 22.0 program modules. Results. There were no statistically significant differences in the frequencies of rs5186 genotypes and alleles of AGTR1 gene between the main group with CHF and the comparison group. Carriage of genotype with the G allele of rs5068 of the NPPA gene was 5.1 times higher in the group with CHF compared with the comparison group by odds ratio (GA + GG vs AA, 95% CI 1.64-16.16; p = 0.003). In women, carriage of the GG and GA genotypes was also associated with an increased odds ratio (OR) of having CHF compared with the AA genotype, OR 5.98 (95% CI 1.24-28.83; p = 0.028). Conclusion: carriage of genotype G allele rs5068 of NPPA gene increases risk of postinfarct chronic heart failure by 5.1 times; rs5186 of AGTR1 gene has no effect on this complication of MI.