PAI-1 4G/5G polymorphism and coronary artery disease risk: a meta-analysis
Zhongshu Liang1, Weihong Jiang1, Mao Ouyang1
1Department of Cardiology, The Third Xiangya Hospital of Central South University 138 Tongzipo Road, Changsha 410013, Hunan, China.
Insights
The plasminogen activator inhibitor-1 (PAI-1) 4G/5G gene polymorphism is linked to an increased risk of coronary artery disease (CAD). This association is particularly notable in Caucasians, Asians, and males, as well as in younger populations.
Area of Science:
- Genetics and Cardiovascular Epidemiology
- Molecular Biology and Disease Mechanisms
Background:
- The plasminogen activator inhibitor-1 (PAI-1) gene 4G/5G polymorphism has been investigated for its association with coronary artery disease (CAD).
- Previous studies have yielded inconclusive results, necessitating a comprehensive meta-analysis.
Purpose of the Study:
- To synthesize existing evidence on the association between the PAI-1 4G/5G polymorphism and CAD risk.
- To clarify the role of this genetic variation in CAD development through meta-analysis.
Main Methods:
- A systematic literature search was conducted across multiple databases (PubMed, Springer Link, Ovid, CNKI, CBM) up to August 10, 2014.
- Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated for 53 studies involving 20,921 CAD cases and 18,434 controls.
- Subgroup analyses were performed based on race, gender, and age.
Main Results:
- The overall meta-analysis revealed a significantly elevated risk of CAD associated with the PAI-1 4G/5G polymorphism (OR = 1.13, 95% CI: 1.05-1.21).
- Subgroup analyses showed increased risk in Caucasians, Asians, males, and younger populations.
- No significant association was found in females or older populations.
Conclusions:
- The PAI-1 4G/5G polymorphism is a potential contributing factor to the development of coronary artery disease.
- The genetic association varies across different ethnic groups, genders, and age strata.
- Further research may elucidate the precise mechanisms linking PAI-1 polymorphism to CAD.
Abstract:
Many epidemiologic studies have investigated the plasminogen activator inhibitor-1 (PAI-1) gene 4G/5G polymorphism and this association with coronary artery disease (CAD). But definite conclusions can not be drawn. Related studies were identified from PubMed, Springer Link, Ovid, Chinese Wanfang Data Knowledge Service Platform, Chinese National Knowledge Infrastructure (CNKI), and Chinese Biology Medicine (CBM) till 10 August 2014. Pooled ORs and 95% CIs were used to assess the strength of the associations. A total of 53 studies including 20921 CAD cases and 18434 controls were included. Significantly elevated CAD risk was found in overall analysis (OR = 1.13, 95% CI: 1.05-1.21, P = 0.0009). In the subgroup analysis by races, significantly increased risk was found in Caucasians (OR = 1.11, 95% CI: 1.03-1.20, P = 0.005) and Asians (OR = 1.20, 95% CI: 1.01-1.42, P = 0.04). In the subgroup analysis by gender, significant association was found in males (OR = 1.15, 95% CI: 1.06-1.25, P = 0.0008), but was not found in females (OR = 1.05, 95% CI: 0.92-1.20, P = 0.47). In the subgroup analysis by age, young populations showed increased CAD risk (OR = 1.19, 95% CI: 1.02-1.37, P = 0.02), but old populations did not show this association (OR = 1.01, 95% CI: 0.82-1.24, P = 0.93). This meta-analysis provides the evidence that PAI-1 4G/5G polymorphism may contribute to the CAD development.
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