Chemokine Receptor Gene (CCR5) Polymorphism in Acute Coronary Syndrome: A Cross-sectional Study

Abstract

Introduction: Acute coronary syndrome is a multifactorial disease with a complex pathogenesis, mainly resulting from the interplay of genetic and environmental risk factors. Chemokines and their receptors play crucial roles in the initiation and progression of atherosclerosis. Chemokine Receptor 5 (CCR5) is an important mediator of leukocyte recruitment and leukopedesis. Most studies conducted on the relationship between CCR5 gene polymorphism and coronary artery disease in different regions and populations worldwide show conflicting results. Aim: To investigate the genetic polymorphism of CCR5 genes associated with patients with acute coronary syndrome in the Vijayapura population. Materials and Methods: A cross-sectional study was conducted at BLDE (Deemed to be University) Shri B.M. Patil Medical College Hospital and Research Centre, Vijayapura, Karnataka, India, involving patients admitted for acute coronary syndrome. A total of 100 patients were admitted with acute coronary syndrome. Nineteen patients with diabetes mellitus were excluded from the study based on the exclusion criteria. Clinical history, examination, electrocardiographic assessments, laboratory profiles, and blood samples were taken for the analysis of CCR5 gene polymorphism as part of the work-up. Patients were classified into two groups: one with the presence of CCR5 polymorphism as Group A (n=6), and the other without polymorphism as Group B (n=75). Parameters such as age, sex, occupation, lipid profile, renal function tests, and CCR5 polymorphism were studied between the groups. The data were statistically analysed. Categorical variables between the two groups were compared using the Chi-square test. Normally distributed continuous variables were compared using independent t-test, and non normally distributed variables were compared using the Mann-Whitney U test. Results: In the present study, the most common age group was 50-70 years with a male predominance of 60.7%. Most of the patients in the study group were farmers (34.7%), followed by housewives (32%) and businessmen (14.7%). The most common risk factors observed in both study groups were smoking and tobacco chewing. Gene sequencing revealed CCR5 gene polymorphism in six out of 81 patients who were labelled as Group A, indicating an incidence of 7.5% (p<0.001). Out of the six positive patients in Group A, three were males and three were females. One patient was 45 years old, while the remaining five were above 60 years old. Conclusion: The present study demonstrates a positive association between CCR5 polymorphism and acute coronary syndrome, indicating that the study population is genetically susceptible to the disease. By screening for high-risk individuals, better and more effective early interventions can be planned, thereby reducing the social burden, morbidity, and mortality associated with the disease.