The GPIIIA PlA2 polymorphism is associated with an increased risk of cardiovascular adverse events.

Authors:
Gennaro Galasso
Gennaro Galasso
Federico II University
Italy
Gaetano Santulli
Gaetano Santulli
Federico II University of Naples
Italy
Federico Piscione
Federico Piscione
University of Salerno
Fisciano | Italy
Valentina Trimarco
Valentina Trimarco
Department of Clinical Medicine
Italy
Raffaele Piccolo
Raffaele Piccolo
Bern University Hospital
Bern | Switzerland
Salvatore Cassese
Salvatore Cassese
Technische Universität München
München | Germany
Prof. Guido Iaccarino, MD, PhD
Prof. Guido Iaccarino, MD, PhD
Federico II University of Naples
Full Professor of Applied Medical Science and Technology
Cardiology
Napoli, Campania | Italy

BMC Cardiovasc Disord 2010 Sep 16;10:41. Epub 2010 Sep 16.

Department of Clinical Medicine, Cardiovascular and Immunologic Sciences, Federico II University School of Medicine, Naples, Italy.

Background: The clinical impact of PlA2 polymorphism has been investigated in several diseases, but the definition of its specific role on thrombotic cardiovascular complications has been challenging. We aimed to explore the effect of PlA2 polymorphism on outcome in patients with atherosclerosis.

Methods: We studied 400 consecutive patients with coronary artery disease (CAD) undergoing percutaneous coronary intervention. A replication study was conducted in 74 hypertensive patients with cerebrovascular events while a group of 100 healthy subjects was included as control population. PlA genotype was determined by PCR-RFLP on genomic DNA from peripheral blood cells. Major adverse cardiac events (MACE), were considered as end points, and recorded at a mean follow up of 24 ± 4.3 months.

Results: The frequencies of PlA2 polymorphism was similar between groups and genotype distribution was in Hardy-Weinberg equilibrium. In patients with CAD, the presence of PlA2 allele was associated with higher incidence of cardiac death (13.1% vs. 1.5%, p = 0.0001), myocardial infarction (10.7% vs. 2.6%, p = 0.004) and needs of new revascularization (34.8% vs. 17.7%, p = 0.010). Accordingly, the Kaplan-Meier analysis for event free survival in patients harboring the PlA2 allele showed worse long-term outcome for these patients (p = 0.015). Cox regression analysis identified the presence of PlA2 as an independent predictor of cardiac death (OR: 9.594, 95% CI: 2.6 to 35.3, p = 0.002) and overall MACE (OR: 1.829, 95% CI: 1.054 to 3.176, p = 0.032). In the replication study, the PlA2 polymorphism increased the risk of stroke (OR: 4.1, 95% CI: 1.63-12.4, p = 0.02) over TIA and was identified as an independent risk factor for stroke (B:-1.39; Wald: 7.15; p = 0.001).

Conclusions: Our study demonstrates that in patients with severe atherosclerosis the presence of PlA2 allele is associated with thrombotic cardiovascular complications.

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http://dx.doi.org/10.1186/1471-2261-10-41DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2954874PMC
September 2010
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