TaqIB polymorphism in cholesterol ester transfer protein (CETP) gene predicts future cardiovascular death in patients experiencing an acute coronary syndrome
TaqIB polymorphism in cholesterol ester transfer protein (CETP) gene predicts future cardiovascular death in patients experiencing an acute coronary syndrome
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DOI：
10.1515/cclm.2009.250
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发表时间：
2009
期刊：
影响因子：
6.9
通讯作者：
X. Pillois;Nahm Phuong Do Thi;Annabel Reynaud;D. Benchimol;L. Lagrost;J. Bonnet
中科院分区：
文献类型：
--
作者：
X. Pillois;Nahm Phuong Do Thi;Annabel Reynaud;D. Benchimol;L. Lagrost;J. Bonnet
摘要背景：胆固醇酯转移蛋白(CETP)在富含甘油三酯(TG)和高密度脂蛋白(HDL)颗粒的重构中起着关键作用。CETP基因的序列变异可能与冠状动脉粥样硬化有关。然而，对各种CETP基因多态性的临床研究表明，冠状动脉预后的数据存在争议。我们的目的是调查TaqIB CETP基因多态性是否可以预测因急性冠状动脉综合征(ACS)住院的前瞻性队列患者的临床结果。方法：连续270名因急性冠脉综合征住院的高加索患者，至少有一条主要血管有明显的冠状动脉病变(狭窄50%)，前瞻性入选并随访57个月。平均年龄65.1±12.5岁，男性占77%。不稳定性心绞痛139例(51.5%)，急性心肌梗死131例(48.5%)。随访数据来自问卷调查。记录的主要复发事件为32例死亡，包括28例心血管死亡和49例合并心血管事件(28例心血管死亡，19例非致命性急性冠脉综合征和2例非致命性中风)。CETP基因分型采用基于限制性片段长度多态性的方法。结果：B2B2基因与合并心血管终点(p<；0.02)显著相关，主要由与心血管死亡相关(p<；0.05)驱动。与B2B2基因相关的心血管死亡危险比为2.2[95%可信区间：1.01-4.94，p<；0.05]。在多变量分析中，除了与他汀类药物的显著交互作用外，没有观察到任何改变，因为纳入了B2B2基因与心血管死亡相关的潜在混杂因素。结论：这些结果表明，B2等位基因纯合子和不服用他汀类药物的患者在最初的急性冠状动脉事件后复发心血管事件的发生率显著增加。这种心血管风险似乎可以通过他汀类药物治疗得到纠正。临床化学实验室医学2009；47：1039-46。
Abstract Background: Cholesterol ester transfer protein (CETP) plays a pivotal role in the remodelling of triglyceride (TG)-rich and high-density lipoprotein (HDL) particles. Sequence variations in the CETP gene may interfere with coronary atherosclerosis. However, clinical studies of various CETP polymorphisms have shown controversial data in coronary artery outcome. We aimed to investigate whether TaqIB CETP gene polymorphism could predict clinical outcome in a prospective cohort of patients hospitalized for an acute coronary syndrome (ACS). Methods: Two hundred and seventy consecutive Caucasian patients hospitalized for an ACS, and having a significant coronary artery disease in at least one major vessel (stenosis >50%), were prospectively enrolled and followed for 57 months. The mean age was 65.1±12.5 years, and 77% were males. One hundred and thirty-nine patients (51.5%) suffered from unstable angina at inclusion and 131 patients (48.5%) presented with an acute myocardial infarction (MI). The follow-up data were obtained from questionnaires. The major recurrent events recorded were 32 deaths comprising 28 cardiovascular deaths and 49 combined cardiovascular events (28 cardiovascular deaths, 19 non-fatal ACS and 2 non-fatal strokes). CETP genotyping was performed using a restriction fragment length polymorphism based method. Results: A significant relation was found between B2B2 genotype and combined cardiovascular end-point (p<0.02), mainly driven by a link with cardiovascular death (p<0.05). The hazard risk ratio for cardiovascular death associated with B2B2 genotype was 2.2 [95% confidence interval (CI): 1.01–4.94, p<0.05]. In multivariate analyses, no modification except for a significant interaction with statin therapy was observed by inclusion of potential confounders for the association of B2B2 genotype with cardiovascular death. Conclusions: These results suggest that patients homozygous for the B2 allele and not taking statin had a strong increase of recurrent cardiovascular event after an initial acute coronary event. This cardiovascular risk seems to be corrected with statin therapy. Clin Chem Lab Med 2009;47:1039–46.