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PAI-1 4G/5G gene polymorphism is associated with angiographic patency in ST-elevation myocardial infarction patients

Bugra Ozkan1, Caglar E Cagliyan, Zafer Elbasan

  • 1Department of Cardiology, Burdur Bucak State Hospital, Turkey.

Coronary Artery Disease
|August 2, 2012
PubMed

Insights

The PAI-1 4G/5G gene polymorphism and time to thrombolytic therapy are independently linked to poor artery patency after treatment for ST-elevation myocardial infarction (STEMI). This finding aids in predicting thrombolysis outcomes.

Area of Science:

  • Cardiovascular Genetics
  • Interventional Cardiology
  • Thrombolysis Research

Background:

  • ST-elevation myocardial infarction (STEMI) management involves thrombolysis to restore blood flow.
  • Vascular patency post-thrombolysis is crucial for patient outcomes.
  • PAI-1 4G/5G polymorphism is investigated for its potential role in vascular events.

Purpose of the Study:

  • To investigate the association between Plasminogen Activator Inhibitor-1 (PAI-1) 4G/5G gene polymorphism and infarct-related artery patency after thrombolysis in STEMI patients.
  • To identify predictors of successful thrombolysis in STEMI.

Main Methods:

  • Prospective study of acute STEMI patients receiving thrombolytic therapy within 12 hours.
  • PAI-1 4G/5G polymorphism analysis from venous blood samples.
  • Coronary angiography within 24 hours to assess infarct-related artery flow (TIMI 0-3).

Main Results:

  • 61 STEMI patients were analyzed; 49.2% carried the PAI-1 4G/5G polymorphism.
  • Patients with the PAI-1 4G/5G polymorphism showed significantly higher rates of 'no flow' (TIMI 0-1) and lower rates of 'normal flow' (TIMI 3) post-thrombolysis.
  • Logistic regression identified PAI-1 4G/5G polymorphism (OR: 4.621) and time to thrombolytic therapy (OR: 0.9898) as independent predictors of post-thrombolytic 'no flow'.

Conclusions:

  • The PAI-1 4G/5G gene polymorphism is independently associated with reduced infarct-related artery patency after thrombolysis in STEMI.
  • Longer time to thrombolytic therapy is also an independent predictor of 'no flow'.
  • These factors can help predict thrombolysis success in STEMI patients.
Abstract

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