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Measurement of Factor V Activity in Human Plasma Using a Microplate Coagulation Assay
Published on: September 9, 2012
Polymorphisms in the genes for coagulation factors II, V, and VII in patients with ischemic heart disease
Y J Feng1, A Draghi, D R Linfert
1Department of Pathology and Laboratory Medicine, Hartford Hospital, Hartford, CT 06102, USA.
Insights
Genetic variations in coagulation factors like prothrombin and factor V are linked to heart disease. While not statistically significant in this study, trends suggest a potential role in acute myocardial infarction and unstable angina. Further research is needed.
Area of Science:
- Cardiovascular Genetics
- Thrombosis Research
- Molecular Cardiology
Background:
- Cardiovascular disease is the leading cause of death in the U.S., with acute myocardial infarctions (AMIs) being a primary contributor.
- Thrombotic coronary artery obstruction, often linked to genetic factors in coagulation, underlies AMIs.
- Polymorphisms in genes for coagulation factors II, V, and VII may increase the risk of ischemic heart disease (IHD).
Purpose of the Study:
- To investigate if mutations in three key coagulation factor genes (prothrombin, factor V, factor VII) predispose individuals to arterial thrombosis.
- To determine the association between these genetic variations and the development of unstable angina (UA) or AMI.
- To explore the genetic underpinnings of ischemic heart disease risk.
Main Methods:
- Examined 125 hospitalized patients (32 AMI, 68 UA, 25 controls) for genetic predisposition to IHD.
- Collected EDTA-anticoagulated whole blood for DNA extraction upon hospital admission.
- Utilized polymerase chain reaction amplification, restriction enzyme digestion, and gel electrophoresis to detect gene polymorphisms.
Main Results:
- Heterozygous frequencies for prothrombin G20210A were 9.4% (AMI), 4.4% (UA), and 4% (controls).
- Factor V Leiden heterozygous frequencies were 9.4% (AMI), 7.4% (UA), and 4% (controls).
- Genotype frequencies for factor VII R353Q and HVR4 size polymorphism showed no statistically significant differences between patient groups and controls.
Conclusions:
- While not statistically significant, observed trends in polymorphism frequencies align with existing literature.
- Phenotypic predisposition to IHD may initially manifest as unstable angina.
- Larger population studies are warranted to clarify the role of these polymorphisms in the sequence of events leading to IHD, including UA.
Background:
Cardiovascular disease remains the leading cause of mortality in the United States, accounting for approximately 33% of all deaths in this country. Of these deaths, most are due to acute myocardial infarctions (AMIs), which are associated with thrombotic coronary artery obstruction and/or occlusion. These events could potentially be due to alterations in genes coding for coagulation factors. Several polymorphisms have been described in the factor II, V, and VII genes, which may predispose one to increased risk for ischemic heart disease (IHD).
Objective:
To determine if mutations in 3 coagulation factor genes could predispose an individual to increased risk for arterial thrombosis as a mechanism for developing unstable angina (UA) or AMI.
Methods:
We examined 125 hospitalized patients (mean age, 53 +/- 6 years, 79 men and 46 women), including 32 with AMI, 68 with UA, and 25 noncardiac controls, for a genetic predisposition for increased risk of IHD. EDTA-anticoagulated whole blood was collected at the time of hospital admission. DNA was extracted, and the polymorphisms were detected by polymerase chain reaction amplification of these genes with subsequent restriction enzyme digestion and gel electrophoresis.
Results:
Our results showed that 3 (9.4%), 3 (4.4%), and 1 (4%) individuals were heterozygous for prothrombin G20210A and 3 (9.4%), 5 (7.4%), and 1 (4%) individuals were heterozygous for factor V Leiden in the AMI, UA, and control groups, respectively. The following genotype frequencies for the factor VII R353Q polymorphism were identified: 25 (78.1%), 56 (82.4%), and 18 (72%) with RR and 7 (21.9%), 12 (17. 6%), and 7 (28%) with RQ in the AMI, UA, and control groups, respectively. No QQ homozygotes were identified. For the HVR4 size polymorphism, the following genotypes were identified: 3 (9.4%), 4 (5.9%), and 5 (20%) individuals with H7H7; 11 (34.4%), 33 (48.5%), and 12 (48%) with H6H7; and 18 (56.2%), 31 (45.6%), and 8 (32%) with H6H6 genotypes in the AMI, UA, and control groups, respectively. There were no H7H5 and H6H5 genotypes found in this study.
Conclusions:
Although the frequency differences of these polymorphisms in patients with AMI and UA were not statistically significant from those in controls, several trends are consistent with what has been reported in the literature. Although any of these or other undefined genetic abnormalities may result in IHD, it is possible that phenotypic predisposition to IHD initially presents as UA. A larger population study addressing the significance of these polymorphisms in the sequence of events that lead to IHD, including cases of UA, is warranted.
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