Role of thrombomodulin gene in Indian population with coronary artery disease

CONTEXT: Thrombomodulin (TM), a natural anticoagulant have been implicated in the pathogenesis of coronary artery disease (CAD) thus emphasizing its potential role as a biomarker. OBJECTIVES: To investigate the role of the TM genetic variants and soluble TM (sTM) plasma levels in Indian population with CAD. MATERIALS AND METHODS: This case-control study involved genotyping of the entire TM gene and sTM levels estimation in 266 subjects. RESULTS: None of the four TM genetic variants identified significantly increased CAD risk in the study population. However, further subgroup analysis revealed that in subjects ≤49 years, C1418T variant (Ala455Val substitution) was significantly associated with CAD. CONCLUSION: The increased CAD risk in subjects ≤49 years due to TM Ala455Val substitution is a promising finding. Further validation on large Indian cohorts is required in order to screen asymptomatic young subjects for CAD risk and to establish the clinical utility of Ala455Val substitution.