A polymorphism of a platelet glycoprotein receptor as an inherited risk factor for coronary thrombosis
A polymorphism of a platelet glycoprotein receptor as an inherited risk factor for coronary thrombosis
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DOI：
10.1056/nejm199604253341703
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发表时间：
1996-04-25
影响因子：
158.5
通讯作者：
GoldschmidtClermont, PJ
中科院分区：
文献类型：
--
作者：
Weiss, EJ;Bray, PF;GoldschmidtClermont, PJ
背景血小板糖蛋白IIb/IIIa是纤维蛋白原和血管性血友病因子的膜受体，在血小板聚集中起重要作用，与急性冠脉综合征的发病有关。为探讨P1（A2）基因多态性与急性冠状动脉综合征的关系，我们对71例心肌梗死或不稳定型心绞痛患者和68例无心脏病史的住院对照进行了病例对照研究，采用反向斑点杂交和等位基因特异性限制性酶切两种方法检测P1（A2）基因型。P1（A2）的患病率是对照组的2.1倍（39.4%vs，19.1%，P=0.01），在60岁以前发病的患者亚组中，PI（A2）的患病率为50%，是60岁以下对照组的3.6倍在具有P1（A2）多态性的受试者中，发生冠状动脉事件的比值比为2.8（95%置信区间，1.2至6.4）。在发病时年龄小于60岁的患者中，优势比为6.2（95%置信区间为1.8至22.4）。我们观察到糖蛋白IIIa基因的P1（A2）多态性与急性冠状动脉血栓形成之间有很强的相关性，并且这种相关性在60岁之前发生冠状动脉事件的患者中最强。(C)1996年，马萨诸塞州医学会。
Background. Platelet glycoprotein IIb/IIIa is a membrane receptor for fibrinogen and von Willebrand factor, and it has an important role in platelet aggregation, It is known to be involved in the pathogenesis of acute coronary syndromes, Previously, we found a high frequency of a particular polymorphism, Pl(A2), of the gene encoding glycoprotein IIIa in kindreds with a high prevalence of premature myocardial infarction.Methods. To investigate the relation between the Pl(A2) polymorphism and acute coronary syndromes, we conducted a case-control study of 71 case patients with myocardial infarction or unstable angina and 68 inpatient controls without known heart disease, The groups were matched for age, race, and sex, We used two methods to determine the Pl(A2) genotype, reverse dot blot hybridization and allele-specific restriction digestion.Results. The prevalence of Pl(A2) was 2.1 times higher among the case patients than among the controls (39.4 percent vs, 19.1 percent, P=0.01), In a subgroup of patients whose disease began before the age of 60 years, the prevalence of Pl(A2) was 50 percent, a value that was 3.6 times that among control subjects under 60 years of age (13.9 percent, P=0.002), Among subjects with the Pl(A2) polymorphism, the odds ratio for having a coronary event was 2.8 (95 percent confidence interval, 1.2 to 6.4). In the patients less than 60 years of age at the onset of disease, the odds ratio was 6.2 (95 percent confidence interval, 1.8 to 22.4).Conclusions. We observed a strong association between the Pl(A2) polymorphism of the glycoprotein IIIa gene and acute coronary thrombosis, and this association was strongest in patients who had had coronary events before the age of 60 years. (C) 1996, Massachusetts Medical Society.