Т786С POLYMORPHISM IN THE ENDOTHELIAL NO SYNTHASE GENE, VASCULAR ENDOTHELIAL GROWTH FACTOR-А IN MYOCARDIAL INFARCTION WITH ST SEGMENT ELEVATION

Abstract

Purpose. To investigate associations of polymorphism Т786С in the eNOS gene with clinical and anamnestic data in patients with ST-segment elevation myocardial infarction (STEMI), the level of vascular endothelial growth factor-A (VEGF-А), clinical course and prognosis of disease. Material and methods. 177 patients with STEMI (139 (78.5%) were male and 38 (21.5%) were female with the average age of (61.73±9.44) years) admitted to intensive care unit of GI “L. T. Malaya Therapy National Institute of AMS of Ukraine” between January 2016 and July 2018 were investigated. Polymerase chain reaction was used to determine allele polymorphism T786C of eNOS gene. Serum level of VEGF by enzyme-linked immunosorbent assay (IBL INTERNATIONAL GMBH, Germany) was determined. After a 6-month observation period combined endpoints (afterinfarction angina, chronic heart failure, cardiovascular death) were assessed. Results. STEMI originated 2.58 times more often in the carriers of 786CC-genotype of eNOS gene in presence of diabetes mellitus type 2 (95% OR (1.10–5.88)), 2.28 times more often in smokers (95% OR (1.03–4.88)), 2.28 times more often – under 55 years (95% OR (1.03–4.88)), 3.03 times more often – in patients with unstable angina before event. Polymorphism 786СС in the eNOS gene was an independent predictor of unfavorable course of postinfarction period (afterinfarction angina, chronic heart failure, cardiovascular death) during 6-month observation period (Р = 0.0029). VEGF-А level increased in the carriers of 786ТТ-genotype of eNOS gene polymorphism with STEMI, and low level was observed in patients with minor 786CC-genotype. These data testifies to possible genetic determinant between VEFG-A level and eNOS gene polymorphism. Conclusion. Observed findings may show new approach to stratification of patients for unfavorable duration of postinfarction period.

Keywords

• stemi, polymorphism т786с in the endothelial no-synthase gene, vegf-а