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Fracassi, Francesco; Niccoli, Giampaolo; Vetrugno, Vincenzo; Cauteruccio, Michele; Buffon, Antonino; Gatto, Ilaria; Giarretta, Igor; Tondi, Paolo; Pola, Roberto; Crea, Filippo

The 9p21 Rs 1333040 polymorphism is associated with coronary microvascular obstruction in ST-segment elevation myocardial infarction treated by primary angioplasty

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  • Media type: E-Article
  • Title: The 9p21 Rs 1333040 polymorphism is associated with coronary microvascular obstruction in ST-segment elevation myocardial infarction treated by primary angioplasty
  • Contributor: Fracassi, Francesco; Niccoli, Giampaolo; Vetrugno, Vincenzo; Cauteruccio, Michele; Buffon, Antonino; Gatto, Ilaria; Giarretta, Igor; Tondi, Paolo; Pola, Roberto; Crea, Filippo
  • imprint: Oxford University Press (OUP), 2019
  • Published in: European Heart Journal: Acute Cardiovascular Care
  • Language: English
  • DOI: 10.1177/2048872617735808
  • ISSN: 2048-8726; 2048-8734
  • Keywords: Cardiology and Cardiovascular Medicine ; Critical Care and Intensive Care Medicine ; General Medicine
  • Origination:
  • Footnote:
  • Description: <jats:sec><jats:title>Background:</jats:title><jats:p> Microvascular obstruction (MVO) after primary percutaneous coronary intervention (pPCI) leads to higher incidence of both early and late complications. A number of single nucleotide polymorphisms in 9p21 chromosome have been shown to affect angiogenesis in response to ischaemia. In particular, Rs1333040 with its three genotypic vriants C/C, T/C and T/T might influence the occurrence of MVO after pPCI. </jats:p></jats:sec><jats:sec><jats:title>Methods:</jats:title><jats:p> We enrolled ST-elevation myocardial infarction (STEMI) patients undergoing pPCI. The Rs1333040 polymorphism was evaluated by polymerase chain reaction-restriction fragment length polymorphism using restriction endonucleases (Bsml). Two expert operators unaware of the patients’ identity performed the angiographic analysis; collaterals were assessed applying Rentrop’s classification. Angiographic MVO was defined as a post-pPCI Thrombolysis In Myocardial Infarction (TIMI)&lt;3 or TIMI 3 with myocardial blush grade 0 or 1, whereas electrocardiographic MVO was defined as ST segment resolution &lt;70% one hour after pPCI. </jats:p></jats:sec><jats:sec><jats:title>Results:</jats:title><jats:p> Among our 133 STEMI patients (mean age 63 ± 11 years, men 72%), 35 (26%) and 53 (40%) respectively experienced angiographic or electrocardiographic MVO. Angiographic and electrocardiographic MVO were different among the three variants ( p= 0.03 and p=0.02 respectively). In particular, T/T genotype was associated with a higher incidence of both angiographic and electrocardiographic MVO compared with C/C genotype ( p=0.04 and p=0.03 respectively). Moreover, Rentrop score &lt;2 detection rate differed among the three genotypes ( p=0.03). In particular T/T genotype was associated with a higher incidence of a Rentrop score &lt;2 as compared with C/C genotype ( p= 0.02). </jats:p></jats:sec><jats:sec><jats:title>Conclusion:</jats:title><jats:p> Rs1333040 polymorphism genetic variants portend different MVO incidence. In particular, T/T genotype is related to angiographic and electrocardiographic MVO and to worse collaterals towards the culprit artery. </jats:p></jats:sec>
  • Access State: Open Access