Search

Abstract: The main objective of this research was to define the association between common mitochondrial DNA (mtDNA) polymorphisms and mitochondrial transcription A gene (TFAM) variants and myocardial infarction (MI) in patients with atherosclerotic diseased vessels. Ten mitochondrial polymorphisms that defined the nine common European haplogroups were genotyped in 500 male patients with early onset MI (<55years) and at least one atherosclerotic coronary vessel (angiographically confirmed), and 500 healthy controls. In addition, we searched for DNA variants in the coding region of the TFAM gene and compared patients and controls for the allele and genotype frequencies. Early onset MI was strongly associated with male gender and tobacco smoking in our population. MtDNA haplogroup H (defined by allele 7028°C) was significantly more frequent in a first group of patients (n =250) compared to controls (n =300), and the association was confirmed in a second group of only smokers (250 patients and 200 controls). For total patients and controls, we obtained a p =0.002 (OR=1.50; 95% CI=1.17–1.92) for H vs. the other haplogroups. We found four common TFAM polymorphisms, with allele/genotype frequencies that did not differ between patients and controls. In conclusion, mitochondrial haplogroup H was associated with early onset MI in male smokers. Our work supported a role for the mtDNA variation in the risk for atherosclerosis and ischemic associated events, likely due to differences in mitochondrial function and reactive oxygen production between the different haplogroups. [ABSTRACT FROM AUTHOR]

Abnormal glucose regulation (AGR) has serious prognostic implications in patients with coronary artery disease (CAD). However there are no records about patients undergoing percutaneous coronary intervention (PCI), for whom the diagnosis of diabetes (known and unknown) may suppose a therapeutical implication of proved benefit (use of IIb/IIIa receptor blockers and drug-eluted stents). Our aim is to assess the current prevalence of abnormal glucose regulation in the patients referred to for percutaneous coronary intervention (PCI) at University Hospital in Asturias, north of Spain. Prospective study. Patients with PCI for ST elevation myocardial infarction (STEMI) are excluded. Those without previous known diabetes undergo a 75-g oral glucose tolerance test (OGTT) 15 days after discharge. We use the WHO (1999) criteria based upon the measurement at FPG and 2 h after glucose intake. Data on 662 successive patients referred to PCI were collected over a period of 7 months. Eighty-two patients were excluded from the study (STEMI), leaving a total of 580 patient population. 167 patients were not studied due to previous known diabetes (28,8%), 75 out of 413 patients without previous diabetes were excluded due to different causes and 338 underwent the OGTT. Population profile: average age 64,9 years, males 79,9%, active smokers 28,3%, hypertension 49,7%, dyslipidemia 48,5%, BMI>30 Kg/m²:35, 7%, previous MI 37,2%, previous revascularization 15,1%, peripheral vascular disease 15,7%, PCI indication (stable angina 23,6%, UA/NSTEMI 76,4%). The results were: known diabetes 28,8%, unknown diabetes after OGTT: 16,2%, IGT: 24,5%, IFG: 1%, normoglycemia 29,5%. Among patients referred to PCI: a) 70,5% present some alterations in hydro carbonate metabolism, b) patients without previous known diabetes exhibited an anomalous OGTT in 57% cases (22% unknown diabetes mellitus). In this population, the OGTT has proved invaluable results to identify a large subset of high-risk patients in which secondary preventive and therapeutic measures should be initiated soon. [ABSTRACT FROM AUTHOR]

The article focuses on the findings of a population-based cross-sectional study that compared the effectivity of oral glucose tolerance test (OGTT) with fasting plasma glucose (FPG) in diagnosing unknown diabetes in patients with coronary artery disease (CAD), conducted in Spain. An OGTT was administered based on the recommendations from the World Health Organization (WHO). The study found that the OGTT is 4 times more likely to diagnose unknown diabetes compared to the FPG.