Τίτλος:
Homozygosity of the TT methylenetetrahydrofolate reductase C677T genotype is an independent long-term predictor of cardiac death in patients with premature myocardial infarction
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Background: Methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism is the main genetic modulator of homocysteine. Data suggest a potential association of homozygosity for the TT MTHFR genotype with premature myocardial infarction (MI). We explored whether TT homozygosity is associated with long-term prognosis in patients with premature ST-segment elevation MI (STEMI). Methods: A total of 265 consecutive patients who had survived their first STEMI ≤35 years of age were followed for a median of 8 years (5–12). Primary endpoints were cardiac death and secondary endpoints were hospitalizations for acute coronary syndrome, myocardial revascularization, arrhythmic event or ischemic stroke. Serum lipids, homocysteine, folate levels were measured at baseline and all patients were also tested for the MTHFR C677T polymorphism. Results: During follow-up 14 patients died (cardiac death) [5.3%] while 84 (31.7%) met the secondary endpoints. In univariate Cox regression analysis TT homozygosity predicted the occurrence of cardiac death (Hazard ratio (HR): 4.071; 95% confidence interval (CI): 1.404–11.809, p =.010) but not the occurrence of secondary endpoints (HR: 0.877; 95% CI: 0.479–1.605, p =.669). TT homozygosity remained an independent predictor of cardiac death after adjustment for conventional risk factors (i.e., sex, diabetes mellitus, hypertension, family history of premature coronary artery disease [CAD]) [HR: 4.350; 95% CI: 1.472–12.856, p =.008]. The association also remained after adjustment for left ventricular ejection fraction or the presence of significant CAD. Conclusions: Homozygosity for the TT MTHFR is an independent long-term predictor of cardiac death in patients with premature STEMI. © 2021 Informa UK Limited, trading as Taylor & Francis Group.
Συγγραφείς:
Rallidis, L.S.
Kosmas, N.
Stathopoulou, E.
Rallidi, M.
Gialeraki, A.
Περιοδικό:
Current Medical Research and Opinion
Εκδότης:
Taylor and Francis Ltd.
Λέξεις-κλειδιά:
fibrinolytic agent; folic acid; genomic DNA; high density lipoprotein cholesterol; homocysteine; lipid; low density lipoprotein cholesterol; methylenetetrahydrofolate reductase (NADPH2); triacylglycerol; methylenetetrahydrofolate reductase (NADPH2), acute coronary syndrome; adult; angioplasty; Article; cholesterol blood level; controlled study; coronary angiography; coronary artery disease; diabetes mellitus; DNA polymorphism; family history; female; folic acid blood level; follow up; genetic association; genotype; heart death; heart left ventricle ejection fraction; heart muscle revascularization; homozygosity; hospitalization; human; human tissue; hypertension; immunoturbidimetry; ischemic stroke; lipid blood level; major clinical study; male; prognosis; ST segment elevation myocardial infarction; triacylglycerol blood level; child; death; genetics; genotype; heart infarction; heart left ventricle function; heart stroke volume; preschool child; risk factor, Child; Child, Preschool; Death; Genotype; Humans; Methylenetetrahydrofolate Reductase (NADPH2); Myocardial Infarction; Risk Factors; Stroke Volume; Ventricular Function, Left
DOI:
10.1080/03007995.2021.1912720
