Introduction. Ischemic heart disease (IHD) is the leading cause of death among adult populations in developed countries. Factors that influence the risk of IHD development are divided into non-modifiable (including genetic factors andfamily history of Coronary Artery Disease) and modifiable. Smoking is the most significant of the modifiable risk factors. Materials and Methods. To exclude the influence of the most significant modifiable cardiovascular risk factor, smokers were not included in the study. A total of 122 non-smokers with Acute Coronary Syndrome (ACS), hospitalized in 2016-2017 years in the department of emergency cardiology of the city hospital, aged 29 to 87 (mean age 66.5±1.01), were included in the study, was composed of 50 males and 72 females. The group studied contained 32 patients with Unstable Angina and 90 patients with Myocardial Infarction of different localizations, including 61 patients with ST elevation on ECG. In all patients a family history of CAD assessment, coronary angiography and identification of the single nucleotide polymorphism rs699947 of gene VEGF-A were conducted. The results are reported in the form of M±m, with categorical data assessment done using Fisher’s exact test, and the odds ratio estimated. Results and discussion. Family history of CAD was observed less frequently among carriers of genotype CC (13.5%) compared to AA (51.7%, ?(Fisher)=0.001, OR=0.146, 95% CI=0.044-0.480) and AC (42.9%, ?(Fisher)=0.003, OR=0.208, 95% CI=0.071-0.614), as well as in all A allele carriers (45.9%, ?=0.0004, OR=0.184, 95% CI=0.065-0.519). In A allele carriers, family history of CAD was observed more frequently than in C allele carriers (31.2%, ?(Fisher)=0,03; OR=1.871, 95% CI=1.015-3.450). Moderate and severe Left Main Coronary Artery (LMCA) stenosis appeared in 17 (13.9%) patients. The highest frequency of stenosis was observed in AC genotype carriers (23.2%) compared to other patients (4.3%, ?(Fisher)=0.0036, OR=4.686, 95% CI=1.431-15.346). The analysis showed that LMCA stenosis appeared less frequently in CC genotype carriers (2,7%) compared to AC (23.2%, ?(Fisher)=0.007, OR=0.092, 95% CI=0.011-0.737) and A allele carriers (18.8%, ?(Fisher)=0.035, OR=0.120, 95% CI=0.015-0.940).
Discussion and conclusions.The findings indicate that allele A rs699947 of VEGF-A gene is associated with hereditary affliction to IHD and the AC genotype is associated with atherosclerosis of LMCA with the identified protective function of CC genotype related to the hereditary affliction to IHD and significant atherosclerosis of LMCA. Carriers of genotype CC rs699947 of gene VEGF-A have a reduced risk of atherosclerosis of LMCA, whereas ACS patients who are carriers of allele A, especially genotype AC, have an increased probability of LMCA stenosis.