title: TCF7L2 polymorphism is associated with low nitric oxide release, endothelial dysfunction and enhanced inflammatory response after myocardial infarction.
abstract: BACKGROUND
  The favorable effects of insulin during myocardial infarction (MI) remain unclear due to the divergence between mechanistic studies and clinical trials of exogenous insulin administration. The rs7903146 polymorphism of the transcription factor 7-like 2 (TCF7L2) gene is associated with attenuated insulin secretion.
  
  
  METHODS
  In non-diabetic patients with ST-elevation MI (STEMI), using such a model of genetically determined down-regulation of endogenous insulin secretion we investigated the change in plasma insulin, C-peptide, interleukin-2 (IL-2), C-reactive protein (CRP), and nitric oxide (NOx) levels between admission (D1) and the fifth day after MI (D5). Coronary angiography and flow-mediated dilation (FMD) were performed at admission and 30 days after MI, respectively. Homeostasis Model Assessment estimated insulin secretion (HOMA2%β) and insulin sensitivity (HOMA2%S).
  
  
  RESULTS
  Although glycemia did not differ between genotypes, carriers of the T-allele had lower HOMA2%β and higher HOMA2%S at both D1 and D5. As compared with non-carriers, T-allele carriers had higher plasma IL-2 and CRP at D5, higher intracoronary thrombus grade, lower FMD and NOx change between D1 and D5 and higher 30-day mortality.
  
  
  CONCLUSIONS
  In non-diabetic STEMI patients, the rs7903146 TCF7L2 gene polymorphism is associated with lower insulin secretion, worse endothelial function, higher coronary thrombotic burden, and higher short-term mortality.
  
  
  CONCLUSIONS
  During the acute phase of MI, a lower capacity of insulin secretion may influence clinical outcome.
authors.affiliation: Cardiology Division, Faculty of Medical Sciences, State University of Campinas (Unicamp), Campinas, SP, Brazil.
authors.forename: Riobaldo
authors.initials: R
authors.lastname: Cintra
authors.affiliation: Cardiology Division, Faculty of Medical Sciences, State University of Campinas (Unicamp), Campinas, SP, Brazil.
authors.forename: Filipe A
authors.initials: FA
authors.lastname: Moura
authors.affiliation: Cardiology Division, Faculty of Medical Sciences, State University of Campinas (Unicamp), Campinas, SP, Brazil.
authors.forename: Luiz S F
authors.initials: LS
authors.lastname: Carvalho
authors.affiliation: Health Science School, University of Brasília (UnB), Brasília, DF, Brazil.
authors.forename: Mauricio
authors.initials: M
authors.lastname: Daher
authors.affiliation: Cardiology Division, Faculty of Medical Sciences, State University of Campinas (Unicamp), Campinas, SP, Brazil.
authors.forename: Simone N
authors.initials: SN
authors.lastname: Santos
authors.affiliation: Health Science School, University of Brasília (UnB), Brasília, DF, Brazil.
authors.forename: Ana P R
authors.initials: AP
authors.lastname: Costa
authors.affiliation: Cardiology Division, Faculty of Medical Sciences, State University of Campinas (Unicamp), Campinas, SP, Brazil.
authors.forename: Valeria N
authors.initials: VN
authors.lastname: Figueiredo
authors.affiliation: Health Science School, University of Brasília (UnB), Brasília, DF, Brazil.
authors.forename: Joalbo M
authors.initials: JM
authors.lastname: Andrade
authors.affiliation: Health Science School, University of Brasília (UnB), Brasília, DF, Brazil.
authors.forename: Francisco A R
authors.initials: FA
authors.lastname: Neves
authors.affiliation: Health Science School, University of Brasília (UnB), Brasília, DF, Brazil; Hospital de Base do Distrito Federal, Brasília, DF, Brazil.
authors.forename: Jose C Quinaglia E
authors.initials: JC
authors.lastname: Silva
authors.affiliation: Cardiology Division, Faculty of Medical Sciences, State University of Campinas (Unicamp), Campinas, SP, Brazil.
authors.forename: Andrei C
authors.initials: AC
authors.lastname: Sposito
keywords: Endothelial function; Mortality; Myocardial infarction; TCF7L2 polymorphism