Myocardial infarction type 1 at young age: Contribution of proatherogenic factors and genetic thrombophilies


DOI: https://dx.doi.org/10.18565/therapy.2023.4.30-37

Shushanova A.S., Gladkikh N.N., Yagoda A.V.

1) Stavropol Regional Clinical Hospital; 2) Stavropol State Medical University of the Ministry of Healthcare of Russia
Abstract. Up to nowadays, there are practically existing no studies on complex research work concerning risk factors for atherosclerosis, lipid component, and genetic thrombophilia in type 1 myocardial infarction (MI) at the age of 25–44 years of patients.
The aim: to study proatherogenic factors and genetic thrombophilias in young patients with type 1 MI.
Material and methods. 100 male patients with type 1 MI aged 25–44 years were examined. Inclusion criteria: informed consent to participate in the study; MI type 1; age 25–44 years. Exclusion criteria: absence of coronary angiography; MI types 2–5; acquired thrombophilia; hypothyroidism; relationship with the patient included in the current study. The comparison group consisted of 100 male patients aged 42–44 years without MI. Risk factors for atherosclerosis and lipid profile were analyzed. 8 genes (1 polymorphism) of the hemostasis system were studied: blood coagulation factors I (FGB: -455G>A), II (F2: 20210G>A), V (F5: 1691G>A), VII (F7: 10976G>A), XIII (F13A1: 103G>T), inhibitor of plasminogen activator type 1 (PAI-1: -675 5G>4G), platelet receptors for collagen (ITGA2: 807C>T) and fibrinogen (ITGB3: 1565T>C).
Results. Young male patients with type 1 MI are characterized by smoking (53%; p <0,0001), arterial hypertension (72%; p <0,0001), type 2 diabetes mellitus (8%; p=0,041), heredity for early CAD (11%; p=0,022), abdominal obesity (45%; p <0,0001), obesity (45%; p <0,0001), carrier of heterozygous G1691A genotypes of the F5 gene (8%; p=0,041), T1565C of the ITGB3 gene (37%; p=0,012) and 5G(-675)4G of the PAI-1 gene (57%; p=0,007). There took place an increase in total cholesterol, LDL, triglycerides and a decrease in HDL. In 5% of patients, heterozygous familial hypercholesterolemia was verified. Based on multivariate analysis, the most significant factors associated with type 1 MI in young male patients were identified: smoking (p=0,010), hypertension (p <0,0001), LDL (p <0,0001), triglycerides (p=0,013), genotype -675 5G/4G of the PAI-1 gene (p=0,002).
Conclusion. Identification of genetic thrombophilias complements the identification of «traditional» proatherogenic factors and allows timely identificate a risk group for type 1 MI at a young age.
Keywords: genetic thrombophilias, myocardial infarction, atherosclerosis
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About the Autors

Alena S. Shushanova, cardiologist at Stavropol Regional Clinical Hospital. Address: 355029, Stavropol, 1 Semashko Str. E-mail: safronovna89@gmail.com. ORCID: https://orcid.org/0000-0002-1337-818X
Natalya N. Gladkikh, MD, professor, professor of the Department of hospital therapy, Stavropol State Medical University of the Ministry of Healthcare of Russia. Address: 355029, Stavropol, 1 Semashko Str. E-mail: ngladkih@mail.ru. ORCID: https://orcid.org/0000-0003-4510-3604
Alexander V. Yagoda, MD, professor, head of the Department of hospital therapy, Stavropol State Medical University of the Ministry of Healthcare of Russia, Honored Scientist of the Russian Federation. Address: 355029, Stavropol, 1 Semashko Str. E-mail: alexander.yagoda@gmail.com. ORCID: https://orcid.org/0000-0002-5727-1640


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