Influence of apoe and slco1b1 genes on lipid spectrum and clinical presentation in patients with myocardial infarction and diabetic nephropathy

Abstract

Abstract Objective To evaluate effect of APOE and SLCO1B1 genes on course of myocardial infarction (MI) in patients with diabetic nephropathy (DN). Materials and methods 185 patients treated about MI were examined (Male – 60.5%, 39.5% – females, average age 64.1±4.2 years). Patients were divided into 2 groups: the first (I) – 93 patients with MI and DN, the second (II) – 92 persons with MI without DN. Polymorphism of the APOE (rs769452) and SLCO1B1 (rs4149056) genes. In first 3 days level of total cholesterol (TH) and low density lipoproteins (LDL) were determined in all patients. Results Based on the data presented in table 1, patients with MI and DN had a statistically more frequent rate of the LeuPro genotype than in the comparison group, relative to group II – 6.2%, p<0.05. Heterozygotes of the ValAla gene (SLCO1B1) were also more often detected in patients of group I – 26.9% versus group II – 9.8%, p<0.05. Analysis of lipid profile indices in heterozygotes revealed a statistically significant difference only between LDL indices, p<0.05. Clinical presentation: acute heart failure (AHF) III–IV classes by Killip – 2.8 times more often in patients of group I, p<0.05. Chronic heart failure (CHF) NYHA III-IV developed 3 times more often in group I than in the second, p<0.05. High-grade ventricular heart rhythm disorders - more often in group I – 24.7%, relative to the control – 8.7%, p<0.05. Relapses of acute coronary syndrome (ACS) occurred 3 times more often in I than the second, p<0.05. Hospital mortality: I – 11.8%, II – 5.4%, p<0.05. Conclusions 1. Heterozygous type of inheritance of the Leu28Pro polymorphism of APOE gene and Val174Ala of SLCO1B1 gene, in patients with MI and DN that was confirmed by high levels of TH and LDL, p<0.05. 2. Clinical course of MI in the group with DN against the background of genetically determined hyperlipidemia, and possibly, in association with it was characterized by multiple complications: AHF and CHF, ventricular arrhythmias, relapses of ACS and deaths. Features of the clinical picture Funding Acknowledgement Type of funding source: None