Influence of endothelial nitric oxide syntase gene polymorphism on prognosis in patients after coronary bypass grafting

Abstract

Background. Development of personalized medicine and study of the genetic basis of cardiovascular diseases are promising areas in modern cardiology.Objective. To evaluate effect of NOS3 gene polymorphism on the prognosis in patients undergoing coronary artery bypass grafting (CABG).Design and methods. The study included 60 patients with stable coronary heart disease (CAD) and multivessel coronary disease according to the SYNTAX I score > 23. The first group included 39 patients — carriers of the 786CC and 786TC genotypes, the second — 21 patients with the 786TT genotype of the NOS3 gene. We accessed the severity of the systemic inflammatory response (SIR) in the postoperative period, the dynamics of changes in the ejection fraction (EF) of the left ventricle, as well as clinical data during 12 months after CABG.Results. The presence of heterozygous and homozygous variants (TC/CC) of the NOS3 gene is associated with a more pronounced and prolonged SIR in the postoperative period. The chances of developing symptoms of acute decompensation of chronic heart failure (CHF) within 12 months after CABG were significantly 4 higher in the group of carriers of TC/CC genotypes.Conclusions. In patients with CAD and carriage of the 786TC/786CC genotypes of the NOS3 gene undergoing CABG, there is a more pronounced and prolonged SIR in the postoperative period, as well as an increased risk of acute decompensation of CHF within 12 months after CABG.