Abstract
Background: Vascular endothelial growth factor (VEGF) is an angiopoetic factor; its variability in circulating levels is mediated by expression of specific VEGF-A gene variants. The aim of this study was to investigate the predictive role of VEGF-A gene polymorphism in clinical outcomes of STelevation myocardial infarction (STEMI) patients.
 Methods: For the study, 135 patients with acute STEMI and 30 healthy volunteers were enrolled. The G634C polymorphism in VEGF-A gene was performed by real-time polymerase chain reaction at baseline. The 6-month combined clinical endpoint was then determined. Design: The study was an open prospective single-center cohort study.
 Results: The entire patient population was distributed into two groups based on the G634G-genotype (n = 70) and combination of G634C and C634C-genotypes (n = 65). Unadjusted multivariate regressive logistic analysis showed peak troponin I levels at admission, Killip class of heart failure > 2, GC/CC polymorphisms in VEGF-A gene, and dynamic increase of NT-pro brain natriuretic peptide (BNP) and VEGF-A levels for 6 months, which were independent predictors for the combined clinical endpoint. After adjustment for dynamic changes of NT-proBNP and VEGF-A levels, we found that GC/CC polymorphisms in the VEGF-A gene was an independent predictor of clinical outcome. Kaplan-Meier curves demonstrated that STEMI patients with GG VEGF-A genotype had a lower frequency of clinical combined endpoint accumulation when compared to those who had GC/CC VEGF-A genotypes (Log-rank p = 0.02).
 Conclusion: The G634C polymorphism in the VEGF-A gene was found to be an independent predictor for 6-month clinical combined endpoint in STEMI patients.
Highlights
Patients with acute ST-elevation myocardial infarction (STEMI) undergoing successful primary percutaneous coronary intervention (PCI) yield significant differences with respect to in-hospital mortality, hospital length of stay, cardiovascular (CV) events and complications, and late survival 1,2
After adjustment for dynamic changes of NT-proBNP and Vascular endothelial growth factor A (VEGF-A) levels, we found that GC/CC polymorphisms in the Vascular endothelial growth factor (VEGF)-A gene was an independent predictor of clinical outcome
There were no significant differences between both STelevation myocardial infarction (STEMI) patient cohorts with respect to age, sex, or CV risk factors
Summary
Patients with acute ST-elevation myocardial infarction (STEMI) undergoing successful primary percutaneous coronary intervention (PCI) yield significant differences with respect to in-hospital mortality, hospital length of stay, cardiovascular (CV) events and complications, and late survival 1,2. The aim of this study was to investigate the predictive role of VEGF-A gene polymorphism in clinical outcomes of STelevation myocardial infarction (STEMI) patients. Unadjusted multivariate regressive logistic analysis showed peak troponin I levels at admission, Killip class of heart failure > 2, GC/CC polymorphisms in VEGF-A gene, and dynamic increase of NT-pro brain natriuretic peptide (BNP) and VEGF-A levels for 6 months, which were independent predictors for the combined clinical endpoint. After adjustment for dynamic changes of NT-proBNP and VEGF-A levels, we found that GC/CC polymorphisms in the VEGF-A gene was an independent predictor of clinical outcome. Conclusion: The G634C polymorphism in the VEGF-A gene was found to be an independent predictor for 6-month clinical combined endpoint in STEMI patients.
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