title: Plasminogen activator inhibitor-1 5G/5G genotype is associated with early spontaneous recanalization of the infarct-related artery in patients presenting with acute ST-elevation myocardial infarction.
abstract: BACKGROUND
  We aimed to examine the association between plasminogen activator inhibitor-1 (PAI-1) genetic polymorphism and early spontaneous recanalization in patients presenting with acute ST-elevation myocardial infarction.
  
  
  METHODS
  Patients admitted to our emergency department with ST-elevation myocardial infarction in the first 6 h of symptom onset were included. An immediate primary percutaneous coronary intervention was performed. Patients were grouped according to the initial patency of the infarct-related artery (IRA) as follows: total occlusion (TO) group [Thrombolysis in Myocardial Infarction (TIMI) 0-1 flow in the IRA], partial recanalization group (TIMI 2 flow in the IRA), and complete recanalization (CR) group (TIMI 3 flow in the IRA). PAI-1 4G/5G polymorphism was detected using the real-time PCR method.
  
  
  RESULTS
  There were 107 patients in the TO group, 30 patients in the partial recanalization group, and 45 patients in the CR group. When we evaluated degrees of patency according to the PAI-1 genotype, TO of the IRA was the highest in patients with the PAI 4G/4G genotype (PAI-1 4G/4G: 66.7%, PAI-1 4G/5G: 65.9%, PAI-1 5G/5G: 40.4%) and CR of the IRA was the highest in patients with the PAI 5G/5G genotype (PAI-1 5G/5G: 38.5%, PAI-1 4G/5G: 19.8%, PAI-1 4G/4G: 17.9%). The distribution of genotypes in different degrees of patency of IRA was statistically significant (P=0.029). In logistic regression analysis, the PAI-1 5G/5G genotype was associated independently with the spontaneous CR of the IRA (odds ratio: 2.875, 95% confidence interval [1.059-7.086], P=0.038).
  
  
  CONCLUSIONS
  Patients with the PAI-1 5G/5G genotype seem to be luckier than others in terms of early spontaneous recanalization of the IRA. Further prospective studies with large patient populations are required for more precise results.
authors.affiliation: Department of Cardiology, Adana Numune Training and Research Hospital, Adana, Turkey. cemrec76@hotmail.com
authors.forename: Caglar E
authors.initials: CE
authors.lastname: Cagliyan
authors.forename: Ozge O
authors.initials: OO
authors.lastname: Yuregir
authors.forename: Mehmet
authors.initials: M
authors.lastname: Balli
authors.forename: Kamuran
authors.initials: K
authors.lastname: Tekin
authors.forename: Rabia E
authors.initials: RE
authors.lastname: Akilli
authors.forename: Sevcan T
authors.initials: ST
authors.lastname: Bozdogan
authors.forename: Serdar
authors.initials: S
authors.lastname: Turkmen
authors.forename: Ali
authors.initials: A
authors.lastname: Deniz
authors.forename: Oytun A
authors.initials: OA
authors.lastname: Baykan
authors.forename: Huseyin
authors.initials: H
authors.lastname: Aslan
authors.forename: Murat
authors.initials: M
authors.lastname: Cayli
mesh_terms: D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D017023:Coronary Angiography; D054059:Coronary Occlusion / Q000150:complications / Q000000981:diagnostic imaging / Q000235:genetics* / Q000503:physiopathology / Q000628:therapy; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000503:physiopathology*; D004562:Electrocardiography; D005260:Female; D005787:Gene Frequency; D020022:Genetic Predisposition to Disease; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000235:genetics* / Q000503:physiopathology / Q000628:therapy; D016017:Odds Ratio; D062645:Percutaneous Coronary Intervention; D010641:Phenotype; D017395:Plasminogen Activator Inhibitor 1 / Q000235:genetics*; D011110:Polymorphism, Genetic; D011379:Prognosis; D060888:Real-Time Polymerase Chain Reaction; D012307:Risk Factors; D012720:Severity of Illness Index; D014654:Vascular Patency / Q000235:genetics*
chemical_list: D017395:Plasminogen Activator Inhibitor 1; C051321:SERPINE1 protein, human