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

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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.