ISSN 2415-3060 (print), ISSN 2522-4972 (online)
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JMBS 2020, 5(1): 115–124
https://doi.org/10.26693/jmbs05.01.115
Clinical Medicine

The Role of Mononucleotide G634c VEGF-A Gene Polymorphism in Patients with Myocardial Infarction in Acute and Remote Periods

Kopytsa N. P., Kutya I. N., Hilova Ya.V.
Abstract

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.

Keywords: acute ST-segment elevation myocardial infarction, vasculoendothelial growth factor-A (VEGF-A), G634C VEGF-A gene polymorphism (rs 2010963)

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