Plasminogen activator inhibitor-1 polymorphism (4G/5G) predicts recurrence in nonhyperlipidemic postinfarction patients

James P. Corsetti, Dan Ryan, Arthur J. Moss, David L. Rainwater, Wojciech Zareba, Charles E. Sparks

    Research output: Contribution to journalArticle

    13 Scopus citations

    Abstract

    Objective: Nonhyperlipidemic postinfarction patients are at high risk for recurrent coronary events by virtue of incident myocardial infarction (MI); however, few studies assess risk beyond incident MI. The aim of this study was to assess such risk as a function of 37 atherosclerosis-associated genetic polymorphisms and 17 blood marker variables. Methods and Results: Screening of polymorphisms in nonhyperlipidemic postinfarction patients revealed significant risk only for the 4G/5G insertion/deletion polymorphism in the promoter of the plasminogen-activator inhibitor-1 (PAI-1) gene. Outcome event mapping, an exploratory data analysis tool, was then applied to define a subgroup (182 patients from total study population of 846 nondiabetic patients) exhibiting maximal functional dependence of risk on the PAI-1 polymorphism. Cox multivariable regression analyses within the subgroup adjusted for significant clinical covariates and medication use as a function of the PAI-1 polymorphism and 17 atherosclerosis-associated blood markers revealed significant risk for patients homozygous for the 4G allele (hazard ratio 4.30, 95% CI 1.98 to 9.33, P=0.00023), and lack of significant risk-association with any blood marker. Conclusion: In a subgroup of normolipidemic postinfarction patients, only the PAI-1 4G/5G polymorphism was associated with recurrent risk from a set of atherosclerosis-associated genetic polymorphisms and blood markers.

    Original languageEnglish (US)
    Pages (from-to)548-554
    Number of pages7
    JournalArteriosclerosis, Thrombosis, and Vascular Biology
    Volume28
    Issue number3
    DOIs
    StatePublished - Mar 1 2008

    Keywords

    • 4G/5G polymorphism
    • Multivariable analysis
    • Plasminogen activator inhibitor-1 (PAI-1)
    • Postinfarction
    • Risk factors

    ASJC Scopus subject areas

    • Cardiology and Cardiovascular Medicine

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