PREDICTORS OF LONG-TERM PROGNOSIS OF MYOCARDIAL INFARCTION: FOCUS ON THE PHARMACOKINETICS
https://doi.org/10.20514/2226-6704-2016-6-2-51-54
Abstract
Aim: to analyze the prognostic value of gene polymorphisms ACE (D/I), SLCO1B1 (Val174Ala), LIPC (C514T), CYP2C19*2, CYP2C19*3, ADRB1 (Ser49Gly), ADRB1 (Arg389Gly) of patients with ST-segment elevation myocardial infarction (STEMI).
Materials and methods. 155 patients with STEMI from 45 to 75 years of age were involved into the study. All patients were prescribed all recommended preparations improving prognosis (statins, angiotensin-converting enzyme inhibitors, beta-blockers, clopidogrel as part of dual antiplatelet therapy) from the fi rst day of hospitalization. Prognosis was assessed by endpoints: cardiovascular mortality, nonfatal myocardial infarction throughout 12 months.
Results. Carriers genotypes *1*2 and *1*3 had in 3,27 times higher risk of recurrent myocardial infarction within 1 year from the STEMI (р=0,03). There was no effect of gene polymorphisms ACE (D/I), SLCO1B1 (Val174Ala), LIPC (C514T), ADRB1 (Ser49Gly), ADRB1 (Arg389Gly) on the probability of recurrent myocardial infarction (p>0,05). Associative links studied polymorphisms with the cardiovascular mortality is not installed (p> 0,05).
About the Authors
M. V. SolodunRussian Federation
Ryazan
S. S. Yakushin
Russian Federation
Ryazan
References
1. Bojcov SA, Jakushin SS, Marcevich SJu, Luk'janov MM, Nikulina NN, Zagrebel'nyj AV et al. Outpatient register of cardiovascular diseases in the Ryazan region (REKVAZA): basic tasks, the experience of creation and the first results. Racional'naja farmakoterapija v kardiologii. 2013; 9 (1): 4-14.
2. Bellil S, Jakushin SS, Aksent'ev SB, Junevich DS. Comparative prognosis in patients of elderly and senile age with a history of myocardial infarction with ST-segment elevation within 12 months of observation, depending on the different schemes of reperfusion therapy. Rossijskij mediko-biologicheskij vestnik imeni akademika I.P. Pavlova. 2015; 1: 90-94.
3. Antman EM., Hand М, Armstrong PW. Focused Update of the ACC/AHA 2004 Guidelines for the Management of Patients with ST-Elevation Myocardial Infarction. J Am Coll Cardiol 2008. 51: 210-247.
4. Shpektor AV, Vasil'eva EJu. Modern approaches to secondary prevention of acute myocardial infarction. Kreativnaja kardiologija. 2014; 2: 71-80.
5. Wallentin L, James S, Storey RF, et al. For the PLATO investigators. Effect of CYP2C19 and ABCB1 single nucleotide polymorphisms on outcomes of treatment with ticagrelor versus clopidogrel for acute coronary syndromes: a genetic substudy of the PLATO trial. Lancet. 2010; 376: 1320–1328.
6. Harmsze AM, van Werkum JW, Ten Berg JM, Zwart B, Bouman HJ, Breet NJ et al. CYP2C19*2 and CYP2C9*3 alleles are associated with stent thrombosis: a case-control study. Eur. Heart J. 2010; 31: 3046-3053.
7. Sibbing D, Stegherr J, Latz W, Koch W, Mehilli J, Dörrler K et al. Cytochrome P450 2C19 loss-offunction polymorphism and stent thrombosis following percutaneous coronary intervention. Eur. Heart J. 2009; 30: 916-22.
8. Liu Y, Liu N, Li W, Shao H, Zhi H, Li J. Relationship of CYP2C19*2 and CYP2C19*3 gene polymorphism with clopidogrel response variability and recurrent cardiovascular events in Chinese patients undergoing percutaneous coronary intervention. Pharmacology. 2013; 91 (3-4): 165-72.
9. Solodun MV, Aksent'ev SB, Nikiforov AA. The first results of evaluation of the prognostic significance of CYP2C19 gene polymorphism in patients with myocardial infarction. Nauka molodyh (Eruditio Juvenium). 2013; 3: 43-47.
Review
For citations:
Solodun M.V., Yakushin S.S. PREDICTORS OF LONG-TERM PROGNOSIS OF MYOCARDIAL INFARCTION: FOCUS ON THE PHARMACOKINETICS. The Russian Archives of Internal Medicine. 2016;6(2):51-54. (In Russ.) https://doi.org/10.20514/2226-6704-2016-6-2-51-54