Relation between K469E gene polymorphism of ICAM-1 and recurrence of ACS and cardiovascular mortality
Ling-Zhi Liu1, En-Ping Wu, Heng-Liang Liu
1Department of Cardiology, People's Hospital of Zhengzhou, No. 33, Huanghe Road, Henan Province 450003, China.
Insights
The K469E gene polymorphism in intercellular adhesion molecule-1 (ICAM-1) is linked to a higher risk of acute coronary syndrome (ACS) recurrence and cardiovascular death. The K allele appears to be an independent risk factor, influenced by hypertension and HDL-C levels.
Area of Science:
- Cardiovascular Genetics
- Molecular Cardiology
- Epidemiology
Background:
- Intercellular adhesion molecule-1 (ICAM-1) plays a role in inflammatory processes relevant to cardiovascular disease.
- Genetic variations, such as the K469E polymorphism, may influence ICAM-1 function and disease susceptibility.
- Acute coronary syndrome (ACS) remains a leading cause of cardiovascular mortality, with recurrence being a significant concern.
Purpose of the Study:
- To investigate the association between the ICAM-1 K469E gene polymorphism and the risk of ACS recurrence.
- To determine the relationship between this ICAM-1 polymorphism and cardiovascular mortality in ACS patients.
- To identify potential modifying factors, such as hypertension and lipid levels, influencing these associations.
Main Methods:
- A cohort of 185 patients diagnosed with ACS was recruited.
- Polymerase chain reaction was employed to genotype the ICAM-1 K469E polymorphism.
- Patients were categorized into groups based on the presence (K allele carriers) or absence of the K allele.
- A five-year prospective follow-up was conducted to collect data on ACS recurrence and mortality.
- Logistic regression analysis, including multivariate adjustments, was used to assess the associations.
Main Results:
- During the follow-up, 38.4% of patients experienced ACS recurrence, and 10 patients died (3 from cardiovascular causes).
- Patients carrying the K allele exhibited significantly higher rates of ACS recurrence and cardiovascular mortality compared to those without the K allele (P<0.01).
- After adjusting for multiple risk factors, the K allele carriers had a 3.31-fold increased risk of ACS recurrence and a 3.53-fold increased risk of cardiovascular mortality (P<0.01).
- The association between the K allele and adverse outcomes weakened when hypertension was considered, and became non-significant when high-density lipoprotein cholesterol (HDL-C) levels were introduced into the model.
Conclusions:
- The ICAM-1 K469E gene polymorphism is associated with increased risk of ACS recurrence and cardiovascular mortality.
- The K allele of the ICAM-1 K469E polymorphism may serve as an independent risk factor for adverse cardiovascular events.
- Hypertension and HDL-C levels appear to be closely related to the impact of this ICAM-1 polymorphism on cardiovascular outcomes.
Objective:
To explore the relation between K469E gene polymorphism of intercellular adhesion molecular-1 (ICAM-1) and the recurrence of ACS and cardiovascular mortality.
Methods:
A total of 185 patients with ACS hospitalized in Department of Cardiology in our hospital from Sep 2007 to Sep 2008 were selected as objectives. Polymerase chain reaction was used to analyze K469E gene polymorphism of ICAM-1. According to the genotypes, they were divided into two groups: group with K allele (KK+KE) and group without K allele (EE). The two groups were followed up prospectively for five years and blood lipid, blood pressure, blood glucose, recurrence and death of ACS were collected when the patients left hospital. The relation between ICAM-1 gene polymorphism and the recurrence of ACS and cardiovascular mortality was analyzed by Logistic regression.
Results:
After long-term follow-up, it was found that ACS recurred on 71 cases (38.4%) and 10 cases died, among which 3 cases died of cardiovascular disease. The recurrence of ACS and cardiovascular mortality in group with K allele were remarkably higher than that in group without K allele (P<0.01). After multivariate Logistic regression adjusted ages, gender, weight indexes, TC, LDL-C, TG, smoking, drinking, family history of cardiovascular disease, history of hypertension and the severity of coronary artery disease, the risks of ACS recurrence and cardiovascular mortality in group with genotype KK+KE was 3.31 and 3.53 times of those in group with genotype EE respectively (P<0.01). When the independent variable of hypertension was introduced in regression analysis, the risks of ACS recurrence and cardiovascular mortality in group with K allele both decreased (P<0.05). When the independent variable of HDL-C was introduced, different genotypes of ICAM-1 weren't relevant with ACS recurrence and cardiovascular mortality (P>0.05).
Conclusions:
K469E gene polymorphism of ICAM-1 was related to ACS recurrence and cardiovascular mortality, K allele probably an independent risky factor and hypertension and to which the level of HDL-C were closely related.
Related Concept Videos
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:30Acute Coronary Syndrome I: Introduction
01:19Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations
01:31Immunoglobulin-like Cell Adhesion Molecules
Ig-CAMs exhibit either homophilic binding (to other Ig-CAMs) or heterophilic binding (to other ligands such as integrins). While most Ig-CAMs...