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C677T polymorphism of the methylenetetrahydrofolate reductase gene is a risk factor of adverse events after coronary revascularization.
- Source :
-
International journal of cardiology [Int J Cardiol] 2004 Sep; Vol. 96 (3), pp. 341-5. - Publication Year :
- 2004
-
Abstract
- Background: A common point mutation (C677T) in the gene for 5,10-methylenetetrahydrofolate reductase (MTHFR) is associated with hyperhomocysteinemia, an independent risk factor and a strong predictor of mortality in patients with coronary artery disease (CAD). The aim of this study was to investigate whether C677T polymorphism can be a predictor of major adverse cardiac events after myocardial revascularization.<br />Methods: We determined MTHFR genotype in 159 patients with CAD undergoing myocardial revascularization [72 percutaneous transluminal coronary angioplasty (PTCA) and 87 coronary artery bypass graft (CABG)]. Recurrent angina, nonfatal myocardial infarction (MI), target vessel revascularization, heart failure and cardiac death were considered major adverse cardiac events that occurred after discharge from index hospitalization.<br />Results: During the follow-up (6.9+/-0.3 months, mean+/-S.E.M.), the composite endpoint accounted for 25.9%, 11.4% and 4.3% for TT, CT and CC genotype (log-rank statistic 5.2, p=0.02), respectively. Subjects with mutant TT genotype had a threefold increase of any cardiac event (hazard ratio [HR]=3.0; 95% [CI], 1.1-8.1). In multiple-variable regression Cox, predictors of events were TT genotype (HR=2.8; 95% CI, 1.01-7.62, p=0.047), low-ejection fraction<40% (HR=4.5; 95% CI, 1.62-12.6, p=0.004) and revascularization procedure (HR=6.1; 95% CI, 1.86-20.34, p=0.003).<br />Conclusions: These data indicate that the TT genotype seems to be significantly associated with major adverse cardiac events after myocardial revascularization in CAD patients, suggesting a potential pathological influence of homocysteine in the clinical outcome.
- Subjects :
- Aged
Coronary Artery Disease surgery
Female
Follow-Up Studies
Humans
Male
Middle Aged
Recurrence
Risk Factors
Treatment Failure
Angioplasty, Balloon, Coronary adverse effects
Coronary Artery Bypass adverse effects
Coronary Artery Disease genetics
Heart Diseases genetics
Methylenetetrahydrofolate Reductase (NADPH2) genetics
Polymorphism, Genetic
Subjects
Details
- Language :
- English
- ISSN :
- 0167-5273
- Volume :
- 96
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- International journal of cardiology
- Publication Type :
- Academic Journal
- Accession number :
- 15301885
- Full Text :
- https://doi.org/10.1016/j.ijcard.2003.06.022