Publication details

Patients with chronic three-vessel disease in a 15-year follow-up study: genetic and non-genetic predictors of survival.

Title in English Patients with chronic three-vessel disease in a 15-year follow-up study: Genetic and non-genetic predictors of survival
Authors

MÁCHAL Jan PÁVKOVÁ GOLDBERGOVÁ Monika HLINOMAZ Ota GROCH Ladislav VAŠKŮ Anna

Year of publication 2014
Type Article in Periodical
Magazine / Source Medicine
MU Faculty or unit

Faculty of Medicine

Citation
web http://journals.lww.com/md-journal/Fulltext/2014/12030/Patients_With_Chronic_Three_Vessel_Disease_in_a.30.aspx
Doi http://dx.doi.org/10.1097/MD.0000000000000278
Field Cardiovascular diseases incl. cardiosurgery
Keywords Atherosclerosis; genetic factors; interleukin 6; survival analysis; three vessel disease
Attached files
Description Genetic and non-genetic predictors of 15-year survival in patients with chronic three-vessel disease (3VD) were investigated. Coronary angiography was performed on 810 subjects with symptoms of stable ischemic heart disease in 1998. The patients with 3VD were genotyped for 23 candidate polymorphisms covering the PPAR-RXR pathway, matrix metalloproteinase-2, renin-angiotensin-aldosterone system, endothelin-1, cytokine genes, MTHFR and APO E variants. Fifteen-year survival data were obtained from the national insurance registry. All data were available in the case of 150 patients with 3VD. Statistical analysis used stepwise Cox regression with dominant, recessive, or additive mode of genetic expression. Involved variables included age, sex, BMI, blood pressure, diabetes, ejection fraction, left main stenosis, previously diagnosed coronary stenosis, myocardial infarction in personal history, and coronary bypass along with polymorphisms pre-selected by log-rank tests. Out of the 23 polymorphisms, four were included in the model construction. SNP in the IL-6 gene rs1800795 (-174 G/C) has been found to be a significant predictor of survival. This SNP was in a linkage disequilibrium with rs1800797 (-597 G/A) in the same gene (D=1.0), which was also found to constitute a significant predictor of survival when rs1800795 was not included in the model construction. Age, increased BMI, diabetes, low EF, and left main stenosis were also significant predictors in all models. Age, increased BMI, diabetes, low ejection fraction, left main stenosis, and genetic variation in the IL-6 promoter were established as significant independent risk factors for the survival of patients with three-vessel disease.
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