Author + information
- Received December 13, 1999
- Revision received March 23, 2000
- Accepted May 24, 2000
- Published online October 1, 2000.
- Jussi Mikkelsson, MD∗,* (, )
- Markus Perola, MD, PhD†,
- Pekka Laippala, PhD‡,
- Antti Penttilä, MD, PhD§ and
- Pekka J. Karhunen, MD, PhD∗,‖
- ↵*Reprint requests and correspondence: Dr. Jussi Mikkelsson, Medical School/B-building, University of Tampere, FIN-33014, Tampere, Finland
We studied the association of the PlA1/A2 polymorphism with coronary thrombosis, myocardial infarction (MI) and sudden cardiac death (SCD) in autopsied victims of sudden death.
Sudden cardiac death is one of the leading symptoms of coronary heart disease in early middle age. Platelet glycoprotein (GP)IIb/IIIa fibrinogen receptors play a key role in coronary thrombosis and MI. PlA1/A2 polymorphism of the gene for GPIIIa has been previously studied in hospital MI patients. Significance of the PlA1/A2 polymorphism in victims of SCD is not known.
The PlA1/A2 polymorphism was studied in the Helsinki Sudden Death Study comprising 700 autopsied middle-aged white Finnish men (33 to 70 years, mean 53 years) who suffered sudden or violent out-of-hospital death.
Prevalence of the A2 allele decreased with age in the series. This decrease was observed among victims of SCD (n = 281) but not in men who died violently (n = 258) or of other diseases (n = 127). Of SCD victims below 50 years, 39.7% were carriers of the A2 allele compared with 28.3% among men under 50 who died of other causes (odds ratio [OR] 2.5, p = 0.01). Men with acute fatal coronary thrombosis (n = 39) were more often (OR 3.4, p < 0.01) carriers of the A2 allele than were men (n = 242) with SCD in the absence of acute coronary thrombosis (48.7% vs. 24.4%, respectively). In addition, men with MI and recent or old thrombosis (n = 67) were more often (OR 3.6, p = 0.005) carriers of the A2 allele than were men (n = 123) with MI in the absence of thrombosis (44.8% vs. 20.3%, respectively). These associations were especially strong in men under 60.
Our results suggest that the A2 allele of the PlA1/A2 polymorphism of GPIIIa is a major risk factor of coronary thrombosis and may be one important predictor of SCD in early middle age.
☆ This study has received financial support from the Finnish Heart Foundation, the Yrjö Jahnsson Foundation, the Pirkanmaa Regional Fund of the Finnish Cultural Foundation, the Medical Research Fund of Tampere University Hospital, the Finnish Foundation of Alcohol Research and the Paavo Ilmari Ahvenainen Foundation.
- Received December 13, 1999.
- Revision received March 23, 2000.
- Accepted May 24, 2000.
- American College of Cardiology