The purpose of the research was to study the relationship of mononucleotide G634C VEGF-A gene polymorphism (rs 2010963) and factors of cardiovascular risk, degree of coronary damage, pattern of structural and functional changes of myocardium, course patients with ST-segment elevation myocardial infarction during hospital and remote (6 months) periods. Material and methods. 135 patients with STEMI were examined. There were 109 (80.7%) males and 26 (19.3%) females, with average age (59.21±8.92) years. The level of VEGF-A was determined with the help of enzyme immunoassay method by using the IBLINTERNATIONAL GMBH reagent kit, (Germany). Allelic G634C VEGF-A gene polymorphism (rs 2010963) was detected by using the polymerase chain reaction (PCR) method in real time. Blood for determination of VEGF-A level and genetic studies was collected on 5th day after ST-segment elevation myocardial infarction. Results and discussion. Genotype distribution of the polymorphic G634C VEGF-A gene (rs 2010963) in patients with ST segment elevation GIM had the following frequency: GG – 51.9%, GC – 47.4%, and CC – 0.7%. Further analysis was performed out in two groups: in patients with a GG-genotype (n=70) and with GC- and CC-genotypes (n=65). Patients with GC+СС genotypes had damaged anterior wall of left ventricle more frequently (р=0,022). Significant difference was detected in the occurrence of combined endpoint after 6 months of observation. Its frequency was significantly higher in the GC+CC-genotypes group (р=0,020). Significantly higher concentration of VEGF-A level was determined in the acute period of the disease in patients with GG-genotype: its level was 314.01 [159.94-627.66] pg/ml, and in GC+CC- genotypes group it was 221.28 [77.58- 440.82] pg/ml, (p = 0.045). In the acute period, there were significant differences in left ventricle end-diastolic volume (P=0.044) and left ventricle end-systolic volume (P=0.039) in the GC+CC-genotypes group. After 6 months no difference in the size of left ventricle cavity was detected. Univariate regression logistic analysis showed that VEGF-A levels in combination with GC+CC-genotypes, heredity, complicated anterior myocardial infarction. The latter could be predictors of adverse events within 6 months (P<0.0001). Conclusion. The patients with acute ST-segment elevation myocardial infarction had significantly higher levels of VEGF-A, and more expressed pronounced changes in left ventricular geometry in GG-genotype group compared to the GC+CC-genotypes group. VEGF-A level, GC+CC-genotypes and complicated course in acute period were high-sensitive predictors of adverse events within 6 months after ST-segment elevation myocardial infarction.
Full text: PDF (Ukr) 463K