Background: Acute myocardial infarction (AMI) in young women represent an extreme phenotype associated with a higher mortality compared with similarly aged men. Prothrombotic gene variants could play a role as risk factors for AMI at young age. Methods: We studied Factor V Leiden, FII G20210A, MTHFR C677T and beta-fibrinogen -455G>A variants by real-time PCR in 955 young AMI and in 698 AMI patients. The data were compared to those obtained in a control group of 909 unrelated subjects from the general population of the same geographical area (southern Italy). Results: In young AMI females, the allelic frequency of either FV Leiden and of FII G20210A was significantly higher versus females of the control group (O.R.: 3.67 for FV Leiden and O.R.: 3.84 for FII G20210A). We did not observe the same result young AMI males or in females with AMI. In fact, among AMI patients we showed only in males that the allelic frequency of the MTHFR C677T variant was significantly higher as compared to the general population. Such difference was due to a significantly higher frequency in AMI males of the MTHFR variant homozygous genotype (O.R. 3.05). Discussion and conclusion: our data confirm that young AMI in females is a peculiar phenotype with specific risk factors as the increased plasma procoagulant activity of FV and FII. On the contrary, the homozygous state for the 677T MTHFR variant may cause increased levels of homocysteine and/or an altered folate status and thus an increased risk for AMI, particularly in males. The knowledge of such risk factors (that may be easily identified by molecular analysis) may help to improve prevention strategies for acute coronary diseases in specific risk-group subjects.
Prothrombotic gene variants as risk factors of acute myocardial infarction in young women.
ZARRILLI, Federica;
2012-01-01
Abstract
Background: Acute myocardial infarction (AMI) in young women represent an extreme phenotype associated with a higher mortality compared with similarly aged men. Prothrombotic gene variants could play a role as risk factors for AMI at young age. Methods: We studied Factor V Leiden, FII G20210A, MTHFR C677T and beta-fibrinogen -455G>A variants by real-time PCR in 955 young AMI and in 698 AMI patients. The data were compared to those obtained in a control group of 909 unrelated subjects from the general population of the same geographical area (southern Italy). Results: In young AMI females, the allelic frequency of either FV Leiden and of FII G20210A was significantly higher versus females of the control group (O.R.: 3.67 for FV Leiden and O.R.: 3.84 for FII G20210A). We did not observe the same result young AMI males or in females with AMI. In fact, among AMI patients we showed only in males that the allelic frequency of the MTHFR C677T variant was significantly higher as compared to the general population. Such difference was due to a significantly higher frequency in AMI males of the MTHFR variant homozygous genotype (O.R. 3.05). Discussion and conclusion: our data confirm that young AMI in females is a peculiar phenotype with specific risk factors as the increased plasma procoagulant activity of FV and FII. On the contrary, the homozygous state for the 677T MTHFR variant may cause increased levels of homocysteine and/or an altered folate status and thus an increased risk for AMI, particularly in males. The knowledge of such risk factors (that may be easily identified by molecular analysis) may help to improve prevention strategies for acute coronary diseases in specific risk-group subjects.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
