title: Connexin37 (GJA4) genotype predicts survival after an acute coronary syndrome.
abstract: BACKGROUND
  GJA4 1019 C > T, MMP3 -1171delA, and SERPINE1 -668delG genotypes have been associated with the risk of incident myocardial infarction. We tested the hypothesis that these genotypes would predict long-term mortality after an acute coronary syndrome (ACS).
  
  
  METHODS
  We assembled a prospective cohort study on 726 patients with ACS admitted between March 2000 and October 2001. Kaplan-Meier estimates and Cox proportional hazards models of 3-year mortality adjusted for age, race, ACS type, prior heart failure, diabetes, and revascularization were used to compare groups.
  
  
  RESULTS
  The GJA4 1019 C > T genotype was significantly related to mortality over 3 years (8.3% vs 14%, for the C/C vs T allele carriers; P = .02), with an adjusted hazard ratio of 1.7 (95% confidence interval 1.05-2.8, P = .03). This finding was consistent in both men and women (hazard ratio = 1.9 and 1.7, respectively) with no significant sex interaction (P = .8). The MMP3 -1171delA and SERPINE1 -668delG genotypes were not significantly related to mortality in the overall population (all P > .4).
  
  
  CONCLUSIONS
  GJA4 1019 C > T genotype predicted risk of death after an ACS, whereas the MMP3 and SERPINE1 genotypes did not. The GJA4 1019 C > T polymorphism may warrant integration into comprehensive risk stratification algorithms for patients with ACS.
authors: Henry Ford Heart and Vascular Institute and Wayne State University, Detroit, MI, USA.
authors: David E
authors: DE
authors: Lanfear
authors: Philip G
authors: PG
authors: Jones
authors: Sharon
authors: S
authors: Marsh
authors: Sharon
authors: S
authors: Cresci
authors: John A
authors: JA
authors: Spertus
authors: Howard L
authors: HL
authors: McLeod
mesh_terms: D000208:Acute Disease; D000789:Angina, Unstable / Q000235:genetics* / Q000401:mortality*; D017630:Connexins / Q000235:genetics*; D005260:Female; D005838:Genotype; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000235:genetics* / Q000401:mortality*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D015996:Survival Rate; D013577:Syndrome; D000097006:Gap Junction alpha-4 Protein
chemical_list: D017630:Connexins; D000097006:Gap Junction alpha-4 Protein