title: The Kozak sequence polymorphism of platelet glycoprotein Ibalpha and risk of nonfatal myocardial infarction and nonfatal stroke in young women.
abstract: Several platelet membrane glycoprotein polymorphisms have been identified as potential risk factors for cardiovascular disease. Recently a nucleotide -5T/C dimorphism in the translation initiation site (Kozak sequence) of the platelet glycoprotein Ibalpha (GPIbalpha) gene was associated with increased platelet surface levels of the GPIb-IX-V receptor complex. The role of this GPIbalpha Kozak sequence polymorphism in the occurrence of arterial thrombotic disease is unknown. We performed genotype analysis of the Kozak sequence polymorphism of GPIbalpha in a population-based study of 18- to 44-year-old women with nonfatal myocardial infarction (MI) (n = 78), nonfatal stroke (n = 106), and 384 demographically similar female control subjects. Analysis of -5T/C genotypes revealed that at least one copy of the C allele was present in 14.1% of MI cases, 23.6% of stroke cases, and 23.7% of controls. The age-adjusted odds ratio for MI in women carrying at least one copy of the C allele was 0.53 (95% confidence interval [CI] 0.27-1.05). The age-adjusted odds ratio for stroke in women carrying at least one copy of the C allele was 0.99 (95% CI 0.59-1.65). Analyses stratified by stroke type (ischemic, hemorrhagic) yielded similar results. In conclusion, young women carrying the C allele of the Kozak sequence polymorphism of GPIbalpha are not at increased risk of MI or stroke. Paradoxically, the C allele may even be associated with a reduced risk of MI in this population. This finding requires further study.
authors.affiliation: Division of Hematology, Department of Medicine, University of Washington, Seattle, WA, USA.
authors.forename: M B
authors.initials: MB
authors.lastname: Frank
authors.forename: A P
authors.initials: AP
authors.lastname: Reiner
authors.forename: S M
authors.initials: SM
authors.lastname: Schwartz
authors.forename: P N
authors.initials: PN
authors.lastname: Kumar
authors.forename: R M
authors.initials: RM
authors.lastname: Pearce
authors.forename: P G
authors.initials: PG
authors.lastname: Arbogast
authors.forename: W T
authors.initials: WT
authors.lastname: Longstreth
authors.forename: F R
authors.initials: FR
authors.lastname: Rosendaal
authors.forename: B M
authors.initials: BM
authors.lastname: Psaty
authors.forename: D S
authors.initials: DS
authors.lastname: Siscovick
mesh_terms: D000293:Adolescent; D000328:Adult; D000483:Alleles; D015897:Comorbidity; D015986:Confounding Factors, Epidemiologic; D003278:Contraceptives, Oral, Hormonal / Q000009:adverse effects; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D005787:Gene Frequency; D020022:Genetic Predisposition to Disease; D005838:Genotype; D006801:Humans; D006937:Hypercholesterolemia / Q000453:epidemiology; D020138:Hyperhomocysteinemia / Q000453:epidemiology; D006973:Hypertension / Q000453:epidemiology; D009203:Myocardial Infarction / Q000453:epidemiology* / Q000209:etiology / Q000235:genetics; D016017:Odds Ratio; D010442:Peptide Chain Initiation, Translational / Q000235:genetics; D019038:Platelet Glycoprotein GPIb-IX Complex / Q000032:analysis* / Q000235:genetics*; D011110:Polymorphism, Genetic; D044469:Racial Groups; D012306:Risk; D020521:Stroke / Q000453:epidemiology* / Q000209:etiology / Q000235:genetics; D019851:Thrombophilia / Q000150:complications / Q000235:genetics*
chemical_list: D003278:Contraceptives, Oral, Hormonal; D019038:Platelet Glycoprotein GPIb-IX Complex