Abstract
Eight common polymorphisms of known myocardial infarction (MI) risk factors (factor V Leiden (FVL), factor V HR2 (FVHR2), factor II 20210G > A (FII), factor VII IVS7 (FVII IVS7), factor VII Arg353Gln (FVII), factor XIII Va134Leu (FXIII), Methylenetetrahydrofolate reductase C677T (MTHFR), Angiotensin Converting Enzyme (ACE)) and environmental risk factors were analyzed in a MI patients of Costa Rica. This case-control study included 186 MI subjects, 95 of them < or = 45 years and 201 age and sex matched controls. With the use of PCR method the polymorphisms were detected and through interviews additional information was collected. Hypercholesterolemia and smoking were associated with a significant risk in younger patients. High fibrinogen level was an important risk factor and interaction with smoking was detected. Mainly, the genotype 34LeuLeu of FXIII showed significant protective effect, (OR 0.32, 95% CI 0.13-0.80) while the other polymorphisms showed no significant difference between the cases and the controls. Carriers of FVII (OR 2.75, 95% CI 1.07-7.02) and FXIII (OR 4.20, 95% CI 2.03-8.67) polymorphisms showed interaction with fibrinogen in the statistical analysis. It was concluded that there was an important interaction between the common risk factors and the polymorphisms (FVII; FXIII) in the development of MI. This is one of the first reports in a Latin-American population dealing with these molecular markers and MI.
Highlights
Myocardial infarction (MI) develops as result of thrombosis in coronary arteries
Hyperhomocystinemia has been documented to be an independent risk factor for thromboembolic and cardiovascular disease (CVD) (Kang et al 1991), and it is often related to a thermolabile variant of the enzyme methylenetetrahydrofolate reductase (MTHFR) (Kang et al 1991, Frosst et al 1995)
51.1% of the cases were < 45 years with a median age of 36.5 years, these subjects will be considered for following analyses as the younger group and 48.9% of the cases were > 45 years with a median age of 57.3 years, these subjects will be considered as the older group
Summary
Myocardial infarction (MI) develops as result of thrombosis in coronary arteries. Numerous studies have examined the relation of common risk factors involvement in atherosclerosis as obesity, hypertension, diabetes mellitus, smoking and abnormalities in the haemostatic system in the pathogenesis of MI (Meade et al 1986, Doggen et al 1998). Mutations of the coagulation factors: factor V Leiden (FVL), factor V gene haplotype R2 (FVHR2) and factor II G20210A (FII 20210 G>A) are known as risk factors for thrombosis in Caucasian populations (Doggen et al 1998, Lunghi et al 1996, Ardissino et al 1999). Few studies have examined the effect of interaction of environmental factors and molecular markers in the risk of MI among younger populations (Herrmann et al 2001, Martini et al 2005), such as the general Costa Rican population (Morera and Barrantes 2004). The aim of this study was to identify the prevalence and impact of the common risk factors and eight polymorphism of genes affecting thrombosis in other populations (FVL, FHR2, FII 20210G>A, FVII IVS7, FVII Arg353Gln, FXIIIVal34Leu, MTHFR, ACE) in one Costa Rican case - control study
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