title: 1059G/C polymorphism within the exon 2 of the C-reactive protein gene: relationship to C-reactive protein levels and prognosis in unstable angina.
abstract: OBJECTIVE
  Patients with unstable angina (UA) and high C-reactive protein (CRP) have increased cardiovascular risk. Whether genetic factors such as the synonymous 1059G/C polymorphism within the exon 2 of the human CRP gene determine CRP levels and outcome is unclear.
  
  
  METHODS
  In 105 consecutive patients with UA, we assessed the CRP 1059G/C polymorphism, CRP plasma levels and interleukin-6 production after in-vitro stimulation of whole blood with lipopolysaccharide (1 ng/ml). Coronary events during a 24-month follow-up were recorded.
  
  
  RESULTS
  CRP levels (median, range) were significantly lower among C-allele carriers (2.3 mg/l, 0.5-26.9) than among GG homozygotes (5.9 mg/l, 0.8-72.12, P=0.009). Interleukin-6 production was lower in C-allele carriers (1645 pg/ml, 832.0-9522) than in GG homozygotes (3929 pg/ml, 670.8-10 582), (P=0.085). At follow-up, 1059C-allele carriers experienced fewer coronary events than 1059GG homozygotes (13 vs. 47%, P=0.021). At multivariable analysis, a CRP level >3 mg/l, but not the 1059G/C polymorphism, was an independent predictor of coronary events (odds ratio 10.04, 95% confidence interval 2.84-35.44, P=0.0002).
  
  
  CONCLUSIONS
  This study shows that the CRP synonymous 1059G/C polymorphism affects CRP levels. No independent association was, however, observed between this polymorphism and clinical outcome in UA.
authors.affiliation: The Institute of Cardiology, University Hospital, The Catholic University, Rome, Italy. vittoria.rizzello@gmail.com
authors.forename: Vittoria
authors.initials: V
authors.lastname: Rizzello
authors.forename: Giovanna
authors.initials: G
authors.lastname: Liuzzo
authors.forename: Giovanna Di
authors.initials: GD
authors.lastname: Giannuario
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Trabetti
authors.forename: Salvatore
authors.initials: S
authors.lastname: Brugaletta
authors.forename: Matteo
authors.initials: M
authors.lastname: Santamaria
authors.forename: Maddalena
authors.initials: M
authors.lastname: Piro
authors.forename: Pier Franco
authors.initials: PF
authors.lastname: Pignatti
authors.forename: Attilio
authors.initials: A
authors.lastname: Maseri
authors.forename: Luigi M
authors.initials: LM
authors.lastname: Biasucci
authors.forename: Filippo
authors.initials: F
authors.lastname: Crea
mesh_terms: D000368:Aged; D000483:Alleles; D000789:Angina, Unstable / Q000235:genetics*; D002097:C-Reactive Protein / Q000235:genetics* / Q000378:metabolism; D005091:Exons; D005260:Female; D006720:Homozygote; D006801:Humans; D015850:Interleukin-6 / Q000378:metabolism; D008070:Lipopolysaccharides / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011110:Polymorphism, Genetic; D016896:Treatment Outcome
chemical_list: D015850:Interleukin-6; D008070:Lipopolysaccharides; D002097:C-Reactive Protein