The 9p21 Rs 1333040 polymorphism is associated with coronary microvascular obstruction in ST-segment elevation myocardial infarction treated by primary angioplasty

Antonino Buffon, Paolo Tondi, Roberto Pola, Filippo Crea, Francesco Fracassi, Giampaolo Niccoli, Vincenzo Vetrugno, Michele Cauteruccio, Ilaria Gatto, Igor Giarretta

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Microvascular obstruction (MVO) after primary percutaneous coronary intervention (pPCI) leads to higher incidence of both early and late complications. A number of single nucleotide polymorphisms in 9p21 chromosome have been shown to affect angiogenesis in response to ischaemia. In particular, Rs1333040 with its three genotypic vriants C/C, T/C and T/T might influence the occurrence of MVO after pPCI. Methods: We enrolled ST-elevation myocardial infarction (STEMI) patients undergoing pPCI. The Rs1333040 polymorphism was evaluated by polymerase chain reaction-restriction fragment length polymorphism using restriction endonucleases (Bsml). Two expert operators unaware of the patients' identity performed the angiographic analysis; collaterals were assessed applying Rentrop's classification. Angiographic MVO was defined as a post-pPCI Thrombolysis In Myocardial Infarction (TIMI)<3 or TIMI 3 with myocardial blush grade 0 or 1, whereas electrocardiographic MVO was defined as ST segment resolution Results: Among our 133 STEMI patients (mean age 63 +/- 11 years, men 72%), 35 (26%) and 53 (40%) respectively experienced angiographic or electrocardiographic MVO. Angiographic and electrocardiographic MVO were different among the three variants (p= 0.03 and p=0.02 respectively). In particular, T/T genotype was associated with a higher incidence of both angiographic and electrocardiographic MVO compared with C/C genotype (p=0.04 and p=0.03 respectively). Moreover, Rentrop score <2 detection rate differed among the three genotypes (p=0.03). In particular T/T genotype was associated with a higher incidence of a Rentrop score <2 as compared with C/C genotype (p= 0.02). Conclusion: Rs1333040 polymorphism genetic variants portend different MVO incidence. In particular, T/T genotype is related to angiographic and electrocardiographic MVO and to worse collaterals towards the culprit artery.
Original languageEnglish
Pages (from-to)703-707-707
JournalEUROPEAN HEART JOURNAL. ACUTE CARDIOVASCULAR CARE
Volume8
DOIs
Publication statusPublished - 2019

Keywords

  • 9p21 polymorphism
  • Acute Coronary Syndrome
  • Aged
  • Angioplasty
  • Chromosomes, Human, Pair 9
  • Coronary Angiography
  • Coronary Occlusion
  • Coronary Vessels
  • Cyclin-Dependent Kinase Inhibitor p21
  • Electrocardiography
  • Female
  • Genetic Predisposition to Disease
  • Genotype
  • Humans
  • Incidence
  • Male
  • Microcirculation
  • Middle Aged
  • Myocardial Infarction
  • Neovascularization, Physiologic
  • Percutaneous Coronary Intervention
  • Polymorphism, Single Nucleotide
  • Rs 1333040
  • ST Elevation Myocardial Infarction
  • ST-segment elevation myocardial infarction
  • Thrombolytic Therapy
  • acute coronary syndromes
  • microvascular obstruction
  • primary percutaneous coronary intervention

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