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The influence of gene polymorphism of enos on the course of afterinfarction period
1Government institution“L.T. Malaya Therapy National institute of the National academy of medical sci - Kharkiv - Ukraine
2Zaporizhzhya State Medical University - Zaporizhzhya - Ukraine
Endothelial NO-synthase (eNOS), constitutive enzyme, expresses in endothelial cells, promotes vascular dilatation. Polymorphism T786C of eNOS gene may influence on different clinical aspects of ST-elevation myocardial infarction (STEMI) and afterinfarction course of disease. Vascular endothelial growth factor-A (VEGF-?) is one of the factors which influences on eNOS generation.
Purpose. To investigate associations of gene polymorphism ?786? of eNOS with clinical and anamnestic data in patients with STEMI, the level of VEGF-?, clinical course and prognosis of disease.
Methods. 177 patients with STEMI, 139 (78,5%) – male and 38 (21,5%) - female, at average age (61,73±9,44) years that were admitted to intensive care unit 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 was determined. After a 6-month observation period combined end point (afterinfarction angina, chronic heart failure no less then III functional class, cardiovascular death) were assessed.
Results. STEMI originated in 2,58 times more often in patients-careers of 786CC-genotype of eNOS gene in the presence of diabetes mellitus type 2 (95% OR (1,10-5,88)), in 2,28 times – in smokers (95% OR (1,03-4,88)), in 2,28 times – at age before 55 years (95% OR (1,03-4,88)), in 3,03 times (95% OR ((1,34-6,57)) – in patients with unstable angina before event. Uni- and multivariative regression analysis showed that polymorphism 786?? of eNOS gene was independent predictor of unfavorable course of afterinfarction period (afterinfarction angina, chronic heart failure, cardiovascular death) during 6-month observation period (?=0,0029). VEGF-? level rice was in patients with STEMI – careers of 786??-genotype of eNOS gene polymorphism and low level – 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 open new approach to stratify patients for unfavorable duration of afterinfarction recovery.
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