n Cardiovascular Journal of South Africa - Plasminogen activator inhibitor type 1 (PAI-1) and platelet glycoprotein IIIa (PGIIIa) polymorphisms in young Asian Indians with acute myocardial infarction : cardiovascular topics




The relationship between polymorphisms in the genes for plasminogen activator inhibitor type 1(PAI-1) and platelet glycoprotein IIIa (PGIIIa), clinical and environmental features, and the risk of premature coronary heart disease (CHD) in Asian Indian subjects living in South Africa, has been investigated.

The prevalence of the PAI-1 promoter 4G/5G and the PGIIIa PIA1A2 polymorphisms was examined in 195 unrelated Asian Indian patients (≤ 45 years) who presented with myocardial infarction (MI). Results were compared with those from 107 unaffected siblings (18-45 years) and 300 healthy age- and race-matched control subjects.
Overall, neither the PAI-1 4G/5G nor the PGIIIa PIA1A2 polymorphism demonstrated an independent risk for MI. No synergistic effect was observed between these two polymorphisms when analysed together. There was a marginal association between the 4G allele of the PAI-1 gene and the risk of MI in individuals who smoked compared with non-smokers (26 vs 11%; = 0.028; OR 2.74; 95% CI 1.04-8.47). The PGIIIa PIA2 allele was, however, strongly associated with a previous history of MI (17 vs 6%; = 0.004; OR 3.00; 95% CI 1.38-6.46), as well as the severity of disease as determined by angiography (single/double- vs triple-vessel disease: 3% vs 15%; = 0.020; OR 0.19; 95% CI 0.02-0.92).
In young Asian Indians who smoke, the PAI-1 4G allele is a mild risk factor for the development of MI. The PGIIIa PIA2 allele constitutes a significant risk for individuals who have a previous history of MI, as well as serving as an indicator for the severity of CHD.


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