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

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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.

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About the authors

Alena S. Shushanova

Stavropol Regional Clinical Hospital

Author for correspondence.
Email: safronovna89@gmail.com
ORCID iD: 0000-0002-1337-818X

cardiologist

Russian Federation, Stavropol

Natalya N. Gladkikh

Stavropol State Medical University of the Ministry of Healthcare of Russia

Email: ngladkih@mail.ru
ORCID iD: 0000-0003-4510-3604

MD, professor, professor of the Department of hospital therapy

Russian Federation, Stavropol

Alexander V. Yagoda

Stavropol State Medical University of the Ministry of Healthcare of Russia

Email: alexander.yagoda@gmail.com
ORCID iD: 0000-0002-5727-1640

MD, professor, head of the Department of hospital therapy, Honored Scientist of the Russian Federation

Russian Federation, Stavropol

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2. Fig. Frequency (%) of risk factors for atherosclerosis in studied young patients with type 1 myocardial infarction and in the control group

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