title: Coronary Artery Atherosclerosis in Hypertensive Patients: The Role of Fibrinogen Genetic Variability.
abstract: OBJECTIVE
  We examined whether the rs180070 and rs2070011 polymorphisms of the fibrinogen gene could affect the risk of coronary artery disease in hypertensive patients by modifying the inflammatory process and coagulation.
  
  
  METHODS
  A total of 744 participants underwent coronary angiography due to symptoms of stable angina, while hypertension was present in 332 patients.
  
  
  RESULTS
  The presence of the A allele (rs180070) was associated with significantly high levels of fibrinogen in hypertensive patients (P=.05). On multivariate analysis, A homozygosity (rs180070) (β = 0.257 ± 18.6; P<.001), but not hypertension status (β = 0.05 ± 11.9; P=.29) was an independent predictor of fibrinogen levels. In hypertensive patients, higher fibrinogen levels>443mg/dL (odds ratio = 3.50; 95% confidence interval, 1.14-10.90; P=.029), but not A homozygosity (odds ratio = 3.00; 95% confidence interval, 0.78-11.90; P = .110) were independent predictors of the presence of coronary artery disease. Moreover, interleukin-6 levels were higher in A homozygotes for the rs180070 polymorphism compared with all other genotypes (P=.046). Indeed, this genotype was the only adjusted independent predictor of interleukin-6 levels (β = 0.151 ± 0.642; P=.032). It was also associated with higher D-dimer levels in hypertension compared with G allele carriers (P=.048).
  
  
  CONCLUSIONS
  The presence of A homozygosity (rs180070) is associated with increased levels of inflammatory mediators and a higher incidence of angiographic coronary artery disease. Importantly, fibrinogen is an independent predictor of the angiographic presence of coronary artery disease in hypertensive patients.
authors.affiliation: 1st Cardiology Department, Athens University Medical School, Hippokration Hospital, Athens, Greece; Barts Heart Centre, St. Bartholomew's Hospital, London, United Kingdom.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Papageorgiou
authors.affiliation: 1st Cardiology Department, Athens University Medical School, Hippokration Hospital, Athens, Greece; Cardiovascular Institute, Wayne State University, Detroit, United States.
authors.forename: Alexandros
authors.initials: A
authors.lastname: Briasoulis
authors.affiliation: 1st Cardiology Department, Athens University Medical School, Hippokration Hospital, Athens, Greece.
authors.forename: Georgios
authors.initials: G
authors.lastname: Hatzis
authors.affiliation: 1st Cardiology Department, Athens University Medical School, Hippokration Hospital, Athens, Greece; Department of Cardiology, John Radcliffe, Oxford University Hospital, Oxford, United Kingdom.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Androulakis
authors.affiliation: 1st Cardiology Department, Athens University Medical School, Hippokration Hospital, Athens, Greece.
authors.forename: Maria
authors.initials: M
authors.lastname: Kozanitou
authors.affiliation: 1st Cardiology Department, Athens University Medical School, Hippokration Hospital, Athens, Greece.
authors.forename: Antigoni
authors.initials: A
authors.lastname: Miliou
authors.affiliation: Department of Cardiovascular Imaging, King's College, London, United Kingdom.
authors.forename: Marietta
authors.initials: M
authors.lastname: Charakida
authors.affiliation: 1st Cardiology Department, Athens University Medical School, Hippokration Hospital, Athens, Greece.
authors.forename: Effimia
authors.initials: E
authors.lastname: Zacharia
authors.affiliation: 1st Cardiology Department, Athens University Medical School, Hippokration Hospital, Athens, Greece.
authors.forename: Spyridon
authors.initials: S
authors.lastname: Papaioannou
authors.affiliation: 1st Cardiology Department, Athens University Medical School, Hippokration Hospital, Athens, Greece.
authors.forename: Ioannis
authors.initials: I
authors.lastname: Paroutoglou
authors.affiliation: 1st Cardiology Department, Athens University Medical School, Hippokration Hospital, Athens, Greece.
authors.forename: Gerasimos
authors.initials: G
authors.lastname: Siasos
authors.affiliation: 1st Cardiology Department, Athens University Medical School, Hippokration Hospital, Athens, Greece.
authors.forename: Zoi
authors.initials: Z
authors.lastname: Pallantza
authors.affiliation: 1st Cardiology Department, Athens University Medical School, Hippokration Hospital, Athens, Greece. Electronic address: drtousoulis@hotmail.com.
authors.forename: Dimitris
authors.initials: D
authors.lastname: Tousoulis
mesh_terms: D000483:Alleles; D050197:Atherosclerosis / Q000097:blood / Q000150:complications / Q000235:genetics*; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000097:blood / Q000150:complications / Q000235:genetics*; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D004247:DNA / Q000235:genetics*; D005260:Female; D005340:Fibrinogen / Q000235:genetics* / Q000378:metabolism; D014644:Genetic Variation; D005838:Genotype; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000150:complications* / Q000235:genetics; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D011110:Polymorphism, Genetic; D012307:Risk Factors
chemical_list: D005340:Fibrinogen; D004247:DNA
keywords: Coronary artery disease; Enfermedad coronaria; Fibrinogen; Fibrinógeno; Hipertensión; Hypertension; Polimorfismos; Polymorphisms