PAI-I 4G/5G polymorphism and sudden cardiac death in patients with coronary artery disease.
The 4G/5G polymorphism of the plasminogen activator inhibitor type I (PAI-I) gene is involved in coronary artery disease (CAD), with the highest risk in 4G/4G homozygotes. The role of PAI-I polymorphism in patients suffering from CAD and history of sudden cardiac death (SCD) has not been addressed yet. We studied the frequency distribution of the PAI-I gene to test the hypothesis that the 4G/4G genotype favors myocardial ischemia and, even in the absence of acute infarction, promotes SCD in patients with CAD.


METHODS
The PAI-I 4G/5G genotypes and PAI-I antigen plasma levels were determined in 97 patients with CAD and a history of SCD treated with an implantable cardioverter defibrillator (ICD) (defibrillator group) comparing to 113 patients with CAD but no history of SCD (control group).


RESULTS
The defibrillator group consisted of significantly more 4G/4G homozygotes and higher PAI-I levels than the control group (44% vs. 24%, 173+/-41 vs. 144+/-49 ng/ml; P<.01). The carriers of 4G allele had a significantly higher risk for SCD (odds ratio (OR) 1.9) with the highest risk in the 4G/4G genotype (OR 3.6, P<.01).


CONCLUSIONS
These results suggest that the PAI-I 4G/4G genotype is associated with SCD in patients suffering from CAD.
Anvari
A
A
Department of Cardiology, University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria.
Schuster
E
E
Gottsauner-Wolf
M
M
Wojta
J
J
Huber
K
K
D000368:Aged; D000483:Alleles; D016022:Case-Control Studies; D003327:Coronary Disease / Q000150:complications*; D016757:Death, Sudden, Cardiac / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D017147:Defibrillators, Implantable / Q000706:statistics & numerical data; D004562:Electrocardiography; D005260:Female; D015637:Gated Blood-Pool Imaging; D005787:Gene Frequency; D020022:Genetic Predisposition to Disease; D005838:Genotype; D006801:Humans; D016013:Likelihood Functions; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D017395:Plasminogen Activator Inhibitor 1 / Q000235:genetics*; D011110:Polymorphism, Genetic; D011401:Promoter Regions, Genetic / Q000235:genetics*; D012044:Regression Analysis; D012307:Risk Factors; D016019:Survival Analysis; D017180:Tachycardia, Ventricular / Q000150:complications / Q000517:prevention & control; D014693:Ventricular Fibrillation / Q000150:complications / Q000517:prevention & control
D017395:Plasminogen Activator Inhibitor 1