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Background and purpose: ST- segment elevation myocardial infarction (STEMI) in young patients has been linked to a variety of genetic and environmental risk factors. The role of several gene polymorphisms in STEMI has been investigated extensively with controversial results. For the first time in Iraq, the current study aims at studying twelve such polymorphisms as well as acquired traditional risk factors in Iraqi patients with STEMI
A total of 70 Iraqi patients diagnosed as STEMI and who were 50 years old or younger, as well as 42 matched controls with no such history were enrolled. The patients were scrutinized for traditional acquired risk factors (smoking, hypertension, diabetes mellitus and dyslipidemia), and their DNA was screened for 12 polymorphisms that may be linked to their arterial thrombosis by multiplex PCR and reverse hybridization. The mutations included: Factor V Leiden, FV H1299R, Prothrombin G20210A, Factor XIII V34L, β-fibrinogen 455 G>A, Plasminogen Activator Inhibitor-I -67 (4G/5G), Human Platelet Antigen-1 (a/b), 5,10-Methylenetetrahydrofolate dehydrogenase reductase (C677T and A1298C), Angiotensin converting enzyme (Del/Ins), Apolipoprotein B and E
The results revealed that minor alleles in none of the 12 gene polymorphisms were significantly associated with STEMI in young. However, it was found that smoking, dyslipidemia and diabetes mellitus were significantly associated with it (p=0.00003, 0.0006 and 0.003) with Odds ratios of 5.8, 4.3 and 8.6 respectively. Hypertension on the other hand, just missed significance (p=0.06).
In conclusion it was found that none of the genetic polymorphisms is implicated, in contrast to quite significant contributions of non-genetic factors as the main risk factors in Iraqi patients with early onset STEMI.
CORONARY: Acute Myocardial Infarction