[Genetic modulation in the inflammatory process of ischemic cardiopathy]

Inflammatory mechanisms and infectious agents, in association with "classic" cardiovascular risk factors, may be involved in the development of coronary atherosclerosis; moreover, recent studies demonstrated a direct role of inflammation in the pathogenesis of acute coronary syndromes, in which the intensity of the individual response to potential environmental inflammatory stimuli seems to influence the magnitude of the inflammatory reaction and the clinical outcome. The variability of this response may be modulated by genetic determinants, in particular by functional polymorphisms of the genes codifying for molecules involved in the inflammatory process. In this review we discuss the association between these polymorphisms and various aspects of ischemic heart disease. Although the association between this syndrome and genetic factors may be confounded by several elements (variable penetrance, different prevalence in different populations and age groups, interaction with environmental risk factors), presently available findings suggest that the inflammatory process in ischemic heart disease might be, at least in part, genetically mediated.