Characteristics and Prognostic Value of the RS2070744 Polymorphism in the NOS3 Gene in Patients with Heart Failure with Reduced Ejection Fraction

Introduction Heart failure with reduced ejection fraction (HFrEF) is a severe clinical condition associated with high mortality and morbidity rates. The –786T/C (rs2070744) polymorphism in the NOS3 gene may influence nitric oxide production and alter cardiovascular outcomes in HFrEF patients. Methods A cross-sectional descriptive study was conducted at Bac Lieu General Hospital, Vietnam from April 2023 to June 2024. Ninety patients with HFrEF (LVEF <40%) underwent genotyping for NOS3 rs2070744 polymorphism using RFLP-PCR. Patients were followed up at 3 and 6 months for heart failure-related readmission and mortality outcomes. Results Of the 90 patients (mean age 64.5 ± 13.3 years; 53.3% male), genotype frequencies were TT (61.1%), CT (32.2%), and CC (6.7%). At 3 months, 32.2% were readmitted for heart failure and 10.0% died; at 6 months, readmission and mortality rates were 25.9% and 8.6%, respectively. The CC genotype was associated with significantly higher readmission and mortality rates at 3 months ( p <0.05). Multivariate Cox regression identified CC/CT genotype (HR=4.24; 95% CI=1.03–17.39; p <0.05) and dyslipidemia (HR=8.63; 95% CI=2.12–41.03; p <0.05) as independent predictors of mortality. Discussion The presence of the C allele may influence adverse cardiovascular outcomes in HFrEF patients, potentially via modulation of nitric oxide production, endothelial dysfunction, and autonomic dysregulation. Conclusion The rs2070744 polymorphism in the NOS3 gene may serve as a prognostic biomarker for poor outcomes in HFrEF. Patients with CC/CT genotypes and dyslipidemia have higher risks of readmission and mortality.