Affiliation:
1. Saint Petersburg I.I. Dzhanelidze research institute of emergency medicine.
Abstract
THE AIM:to assess the effect of APOE and SLCO1B1 gene polymorphism on the course of myocardial infarction (MI) associated with acute kidney injury (AKI) in hospital and long-term periods.PATIENTS AND METHODS:132 patients with МI were examined, which were divided into 2 groups: the first (I) – 68 patients with MI and AKI, the second (II) – 64 people with MI without AKI.RESULTS:In the distribution of genotypes, polymorphism of Leu28Pro of the APOE gene in the studied groups was revealed that LeuPro was more often inherited in patients of group I – 20,6 %, the average value of total cholesterol (TC) – 6,01±0,3 mmol/l, and low density lipoproteins (LDL) – 3,37±0,21 mmol/l, compared with patients of group II, where the LeuPro genotype – 6, 2 %, TC – 5,03±0,3 mmol/l, LDL – 2,38±0,3 mmol/l, p<0,05. A similar situation was typical for the polymor phism Val174Ala SLCO1B1 gene, where ValAla in patients of group I-26,5 %, in II-12,5 %, p<0.05. In heterozygotes I sample TC-5,59±0,3 mmol/l, and LDL – 3,30±0,14 mmol/l, in group II TC – 5,19±0,29 mmol/l, LDL – 2,75±0,23 mmol / l, p<0,05. The clinical picture of the hospital period in patients with MI and AKI, proceeded with the development of a greater number of complications, which reflected in the high mortality in group I – 16,2 %, in group II – 4,7 %, p<0,05. In the posthospital period, against the background of atorvastatin administration in both study groups, there was a positive trend of decrease in TC and LDL, but it was not possible to achieve the targets. Mortality in the long-term period in group I – 15,4 %, in group II-2,0 %, p<0.05.CONCLUSIONS:in patients with MI and AKI on the background of a more severe clinical course of the disease, both in hospital and in the long-term period, rare allelic variants of the genes APOE and SLCO1B1 were more often determined, which negatively affected the lipid profile.
Publisher
Non-profit organization Nephrology
Reference14 articles.
1. Rossijskoe kardiologicheskoe obshchestvo. Nacionalnoe obshchestvo po izucheniyu ateroskleroza. Rossijskoe obshchestvo kardiosomaticheskij reabilitacii i vtorichnoj profilaktiki. Diagnostika i korrekciya narushenij lipidnogo obmena s celyu profilaktiki i lecheniya ateroskleroza. Rossijskie rekomendacii (v peresmotr). Rossijskij kardiologicheskij zhurnal 2012; (4): 4–32. doi:org/10.15829/1560-4071-2012-4s1.
2. Rossijskoe kardiologicheskoe obshchestvo. Nacionalnoe obshchestvo po izucheniyu ateroskleroza. Rossijskoe obshchestvo kardiosomaticheskij reabilitacii i vtorichnoj profilaktiki. Diagnostika i korrekciya narushenij lipidnogo obmena s cel'yu profilaktiki i lecheniya ateroskleroza. Rossijskie rekomendacii (V I peresmotr). Ateroskleroz i Dislipidemii 2017; 28(3):5–23
3. Sychev DA, Semenov AV, Ramenskaya GV et al. Pharmacogenetics of HMG-CoA reductase inhibitors (statins): perspectives of individualized, genotype-based therapy. Сardiovascular therapy and prevention 2006;5(1):100–104. doi: 10.1016/j.atherosclerosis.2004.09.004
4. Heng CK, Saha N, Tay JS. Lack of association of apolipoprotein E polymorphism with plasma Lp(a) levels in the Chinese. Clin.Genetics 1995; (48): 120–153. PMID:8556815
5. Shuev GN, Sychev DA, Grachev AV. Gene polymorphism of SLCO1B1, associated with the development of statin-induced myopathy, levels of vitamin D in Russian patients with hyperlipidemia. Сreative cardiology 2015; (4):40–45. doi: 10.15275/kreatkard.2015.04.05