Platelet glycoprotein IIb HPA-3 polymorphism and acute coronary syndromes

Lekakis, John; Bisti, Sofia; Tsougos, Elias; Papathanassiou, Athanasios; Dagres, Nikolaos; Ikonomidis, Ignatios; Soteriadou, Ekaterini; Tselepis, Alexandros D.; Goudevenos, John; Kremastinos, Dimitris Th.

doi:10.1016/j.ijcard.2007.04.039

« Previous Next »International Journal of Cardiology
Volume 127, Issue 1 , Pages 46-50, 23 June 2008

Platelet glycoprotein IIb HPA-3 polymorphism and acute coronary syndromes

John Lekakis
- Department of Cardiology, Attikon University Hospital, Athens University, Greece
- Corresponding author. 12 Iridanou str, 115 28 Athens, Greece. Tel.: +30 210 7299200; fax: +30 210 7299201.
Sofia Bisti
- Department of Microbiology, Hellenic Pasteur Institute, Athens, Greece
Elias Tsougos
- Department of Cardiology, Attikon University Hospital, Athens University, Greece
Athanasios Papathanassiou
- Department of Cardiology, University of Ioannina, Greece
Nikolaos Dagres
- Department of Cardiology, Attikon University Hospital, Athens University, Greece
Ignatios Ikonomidis
- Department of Cardiology, Attikon University Hospital, Athens University, Greece
Ekaterini Soteriadou
- Department of Microbiology, Hellenic Pasteur Institute, Athens, Greece
Alexandros D. Tselepis
- Laboratory of Biochemistry, Department of Chemistry, University of Ioannina, Greece
John Goudevenos
- Department of Cardiology, University of Ioannina, Greece
Dimitris Th. Kremastinos
- Department of Cardiology, Attikon University Hospital, Athens University, Greece

Received 25 July 2006; received in revised form 30 March 2007; accepted 4 April 2007. published online 13 June 2007.

Abstract

Background

There is considerable research interest about the platelet GPIIb/IIIa receptor polymorphisms in CAD.

Methods

We investigated differences in the frequency of the polymorphism in the GPIIb subunit of the receptor HPA-3 (a and b allele) between patients with more extensive coronary thrombosis such as patients with ST segment elevation (STEMI) and those with less extensive coronary thrombosis such as those with non-ST elevation myocardial infarction (NSTEMI), unstable angina (UA) or chronic CAD. We studied 118 CAD patients, of which 38 suffered from STEMI, 62 from NSTEMI or UA and 18 from chronic CAD and 15 healthy individuals. Patients were followed-up for 21±6 months for occurrence of death, myocardial infarction and revascularization.

Results

Seventeen out of 38 (45%) patients with STEMI were homozygous for the HPA-3 b allele compared to 6 out 62 (10%) with NSTEMI-UA , 4 out of 18 (22%) with chronic CAD and 2 out of 15 (13%) healthy controls (χ²=16,4, p=0.03.)

Homozygous patients for the HPA-3b exhibited a 5-fold higher risk for STEMI compared to heterozygous patients for HPA-3b or homozygous for HPA-3a allele (OR: 5.90, 95% CI: 2.15–16.54, p=0.01) after adjustment for age, sex and risk factors. The HPA-3 genotypes were not related with cardiovascular events during follow-up.

Conclusions

Among patients with an acute coronary syndrome those being HPA-3b homozygous have a tendency to develop ST segment elevation myocardial infarction instead of non-ST segment elevation infarction or unstable angina. There is no association between the HPA-3 genotypes and future cardiovascular events.

Keywords: Platelets, GPIIb/IIIa receptors, Genepolymorphisms, Acute coronary syndromes