Relationship between antithrombin III genetic polymorphism and individual variation in anticoagulant effect of heparin in patients of different nationalities

Abstract

Objective To evaluate the relationship between antithrombin Ⅲ(ATⅢ)genetic polymorphism and individual variation in anticoagulant effect of heparin in the patients of different nationalities. Methods Sixty patients of Uighur nationality and 60 patients of Han nationality, aged 18-64 yr, with body mass index of 21-25 kg/m2, of American Society of Anesthesiologists physical statusⅠ-Ⅲ, undergoing elective cardiac surgery under cardiopulmonary bypass, were divided into Uighur group and Han group, respectively.ATⅢ gene polymorphism was detected by polymerase chain reaction(A/G was heterozygous, A/A and G/G were homozygous). Heparin sodium was intravenously injected at 5 min before the start of cardiopulmonary bypass with an amount of ACT ≥ 480 s. The amount of heparin and protamine, intraoperative blood transfusion and postoperative 24 h drainage(pericardium, mediastinum/thoracic cavity)were recorded.Activated partial thromboplastin time and prothrombin time were measured at 10 min before operation and 24 h after operation. Results Compared with Han group, the amount of heparin, ratio of protamine to heparin for heparin neutralization and requirement for intraoperative blood transfusion were significantly decreased, the postoperative drainage volume was decreased, activated partial thromboplastin time was shortened at 24 h after operation, the frequency of A/A genotype was increased and the frequency of G/G genotype was decreased at ATⅢ gene single-nucleotide polymorphism sites rs5877 and rs5878, and the minimum allele(A>G)frequency was increased in Uighur group(P<0.05). Conclusion ATⅢ gene polymorphism may be one of the mechanisms underlying individual variation in anticoagulant effect of heparin between the patients of Uighur nationality and Han nationality. Key words: Antithrombin Ⅲ; Polymorphism, single nucleotide; Heparin; Ethnic groups