title: Association of the plasminogen activator inhibitor-1 gene 4G/5G polymorphism with ST elevation acute myocardial infarction in young patients.
abstract: OBJECTIVE
  To investigate the role of the 4G/5G polymorphism in the plasminogen activator inhibitor-1 (PAI-1) gene in patients with ST-elevation myocardial infarction (STEMI) aged < or =45 years and its influence on regulation of the plasma PAI-1 concentration.
  
  
  METHODS
  This case-control study included 127 consecutive patients aged < or =45 years with a diagnosis of STEMI who were admitted to a cardiovascular intensive care unit and 127 controls recruited between January 2006 and March 2007. Participants were genotyped for the 4G/5G polymorphism using the polymerase chain reaction and restriction fragment length polymorphism analysis, and their plasma PAI-1 concentrations were measured. Informed consent was obtained from all participants.
  
  
  RESULTS
  There was a significant difference in genotype distribution between the two groups (P< .002). The 4G allele occurred more frequently in the patient group (P=.032). In addition, there were significant independent associations between STEMI and the 4G allele (i.e., 4G/4G plus 4G/5G; odds ratio [OR]=2.29; 95% confidence interval [CI], 1.12-4.68; P=.022), smoking (OR=23.23; 95% CI, 8.92-60.47; P< .001), a family history of cardiovascular disease (OR=4.66; 95% CI, 2.06-10.52; P=.001) and hypertension (OR=5.42; 95% CI, 1.67-17.56; P=.005). The plasma PAI-1 concentration was higher in individuals who were homozygous for the 4G allele (P< .001).
  
  
  CONCLUSIONS
  The study findings indicate that the 4G allele is an independent risk factor for acute myocardial infarction in young patients, as are smoking, hypertension and a family history of inherited cardiovascular disease.
authors.affiliation: Unidad de Investigación Médica en Trombosis, Hemostasia y Aterogénesis, Instituto Mexicano del Seguro Social, México DF, México. irmaisordia@yahoo.com.mx
authors.forename: Irma
authors.initials: I
authors.lastname: Isordia-Salas
authors.forename: Alfredo
authors.initials: A
authors.lastname: Leaños-Miranda
authors.forename: Irma M
authors.initials: IM
authors.lastname: Sainz
authors.forename: Elba
authors.initials: E
authors.lastname: Reyes-Maldonado
authors.forename: Gabriela
authors.initials: G
authors.lastname: Borrayo-Sánchez
mesh_terms: D000208:Acute Disease; D000328:Adult; D004562:Electrocardiography; D005260:Female; D005787:Gene Frequency; D005838:Genotype; D006801:Humans; D008297:Male; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology* / Q000235:genetics* / Q000503:physiopathology; D016017:Odds Ratio; D017395:Plasminogen Activator Inhibitor 1 / Q000235:genetics*; D011110:Polymorphism, Genetic; D012307:Risk Factors
chemical_list: D017395:Plasminogen Activator Inhibitor 1