The effect of polymorphic alleles carriage of the VKORC1 gene on clinical and laboratory ­parameters in patients with acute coronary syndrome

Abstract

Background. The role of the VKORC1 (1639G>A, rs9923231) gene polymorphism in hypersensitivity to warfarin and hypocoagulation is known. It has been proven that polymorphisms in the VKORC1 gene can lead to the progression of atherosclerosis and hypercoagulability, and, therefore, can be factors contributing to the development of acute coronary syndrome.

Aim. To study the effect of polymorphic genotypes carriage of the VKORC1 gene on the clinical and laboratory parameters of patients with acute coronary syndrome.

Material and methods. The pilot observational cross-sectional study involved 77 patients who were under observation in the conditions of the Federal Center for Cardiovascular Surgery in Astrakhan and the vascular center of Kirov City Hospital No. 3 (Astrakhan), from October 2020 to May 2021. Genotyping for CYP2C9, VKORC1, CYP4F2 on a PCR analyzer was performed. For statistical processing, the Hardy–Weinberg and Student criteria; 95% confidence interval were determined using Statistica Trial 13 and IBM SPSS Statistics 26.0. Differences were considered statistically significant at p <0.05.

Results. Significant differences related to the frequency of hemodynamically significant stenosis in homozygous carriers of the GG gene for VKORC1 compared with the group of carriers of the GA genotype — 3 (8.8%) versus 7 (22.5%); p=0.0058. Carriers of the GA and GG genotypes were most often diagnosed with myocardial infarction (Q- and non-Q-forming). Carriers of the AA genotype were more likely to have new or progressive angina pectoris. The level of hyperglycemia and triglyceridemia was the highest in the group of patients with the AA genotype, VKORC1 gene.

Conclusion. Statistically significant differences were established in the clinical and laboratory parameters of patients with acute coronary syndrome, carriers of different genotypes of the VKORC1 gene.

Keywords

acute coronary syndrome / gene polymorphism / warfarin sensitivity / hypercoagulability

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Funding

Научное исследование выполнено в рамках реализации государственного задания Министерства здравоохранения Российской Федерации «Разработка алгоритмов персонализированного назначения антиагрегантов у пациентов с острым коронарным синдромом».

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