Molecular epidemiology of acute coronary syndrome in Japan : Large-scale, prospective, multicenter clinical investigation

2000年，我们进行了(1)研究急性心肌梗死后住院死亡率的预测因素，(2)调查肺炎衣原体抗体与急性心肌梗死发病的关系，以及肺炎衣原体感染和经典冠状动脉危险因素对急性心肌梗死风险的联合作用，以及(3)阐明急性心肌梗死发病的遗传背景。(1)住院死亡率的预测因素改变急性心肌梗死我们发现侧支循环影响更好的住院心理，其影响被年龄、糖尿病、肺炎衣原体感染对急性心肌梗死发病的影响我们发现肺炎衣原体IgA抗体滴度对急性心肌梗死的预测价值仅为弱阳性，且无统计学意义。然而，肺炎衣原体IgA抗体滴度高与肥胖、高胆固醇血症和吸烟等经典冠状动脉危险因素的联合作用更大。(3)遗传背景与急性心肌梗死发病机制之间的关联我们使用高通量多重聚合酶链式反应-侵入者分析方法对92,788个随机选择的基于基因的单核苷酸多态(SNPs)进行了全基因组关联研究。我们发现两个SNP与急性心肌梗死显著相关。我们现在正在制作该基因座的致密SNP图谱，用于连锁不平衡定位，随后对基因产物进行功能分析。

In 2000, we performed (1) to examine the predictors of in-hospital mortality alter acute myocardial infarction, (2) to investigate the association between Chlamydia pneumoniae IgG and/or IgA antibodies and the onset of acute myocardial infarction and joint effects of Chlamydia pneumoniae infection and classic coronary risk factors on risk of acute myocardial infarction, and (3) to clarify genetic background in the pathogenesis of acute myocardial infarction.(1) Predictors of in-hospital morality alter acute myocardial infarctionWe showed that collateral vessel influences better in-hospital mentality and its effect is modified by aging, diabetes mellitus, and preinfarction angina.(2) The effect of Chlamydia pneumoniae infection on the onset of acute myocardial infarctionWe showed that the predictive value of Chlamydia pneumoniae IgA antibody titer for acute myocardial infarction is only weakly positive and of marginal statistical significance. However, the joint effects of high C pneumoniae IgA antibody titers together with classic coronary risk factors such as obesity, hypercholesterolemia, and smoking are greater.(3) The association between genetic background and the pathogenesis of acute myocardial infarctionWe performed a genome-wide association study using the high-throughout multiplex PCR-Invader assay method at 92,788 randomly selected gene-based singe-nucleotide polymorphisms (SNPs). We found that two SNPs were significantly associated with acute myocardial infarction. We are now making a dense SNP map of this locus for linkage disequilibrium mapping, followed by functional analyses of gene products.