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Genetic factors of the hemostatic system in young patients with myocardial infarction
Irma Isordia-Salas1, Antonia Lorena Mendoza-Valdez, Eduardo Almeida-Gutiérrez
1Unidad de Investigación Médica en Trombosis, Hemostasia y Aterogénesis, Hospital General Regional 1 "Carlos MacGregor Sánchez Navarro," Mexico, D.F., Mexico. irmaisordia@yahoo.com.mx
Insights
Genetic factors significantly contribute to acute myocardial infarction (AMI), a major cause of death. Identifying these genetic variants is crucial for developing targeted treatments and early prevention strategies for coronary artery disease (CAD).
Area of Science:
- Cardiovascular Medicine
- Genetics
- Public Health
Background:
- Coronary artery disease (CAD) is the leading global cause of mortality.
- Acute myocardial infarction (AMI), a primary thrombotic complication of CAD, affects approximately 9% of new myocardial infarction (MI) cases in individuals under 45.
- While modifiable risk factors like hypertension and diabetes are known, a significant number of AMI patients lack these predispositions.
Purpose of the Study:
- To explore the role of genetic variants in the development of AMI.
- To identify genetic factors contributing to CAD beyond traditional risk factors.
- To inform the development of novel therapeutic and preventive strategies for CAD.
Main Methods:
- Review of recent research identifying genetic polymorphisms associated with AMI.
- Analysis of genes involved in coagulation, fibrinolysis, platelet function, and endothelial function.
- Investigation into the interplay of gene-environment factors in AMI pathogenesis.
Main Results:
- Several genetic variants in genes related to hemostasis, platelet receptors, homocysteine metabolism, endothelial dysfunction, and oxidative stress have been linked to AMI.
- These genetic factors play a role in thrombus formation and arterial occlusion.
- A substantial portion of AMI cases are influenced by genetic predispositions, even in the absence of traditional risk factors.
Conclusions:
- Genetic identification is key to advancing CAD treatment strategies.
- Understanding inherited risk factors enables early identification of at-risk individuals for preventive measures.
- Continued research into acquired and inherited risk factors is essential for managing this complex disease.
Background:
Coronary artery disease (CAD) is the first cause of death worldwide and represents a public health issue in our country. Acute myocardial infarction (AMI) represents the main thrombotic complication of CAD. Approximately 9% of the new events of MI occur in patients <45 years of age.
Discussion:
AMI is produced by development of a thrombus at the site of an atherosclerotic plaque that initiates abrupt arterial occlusion, with ischemia and cell death. AMI results from the interaction of gene-environment factors. There are several modifiable factors such as hypertension, diabetes, smoking, obesity, and hypercholesterolemia associated with AMI. However, in a large number of patients with AMI, modifiable risk factors are not present. In the last decade, several genetic variants (polymorphisms) have been identified associated with AMI in genes related to coagulation proteins, fibrinolytic system, platelet receptors, homocysteine metabolism, endothelial dysfunction, abnormal blood flow and oxidative stress.
Conclusions:
Identifying the genes associated with CAD will allow us to develop more efficacious treatment strategies and will also help to identify at-risk subjects, thereby enabling the introduction of early preventive measures. Thus, many research efforts continue to address the identification of acquired and inherited risk factors of this complex disease.
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