Key result
The K allele of the ICAM-1 K469E polymorphism was associated with increased risks of ACS recurrence (OR 3.31) and cardiovascular mortality (OR 3.53) compared to the EE genotype (P<0.01).
Why the study?
Does the K allele of the ICAM-1 K469E polymorphism increase the risk of ACS recurrence and cardiovascular mortality in patients with ACS?
Cohort (n=185)
No
Does the K allele of the ICAM-1 K469E polymorphism increase the risk of ACS recurrence and cardiovascular mortality in patients with ACS?
Odds Ratio: 3.31
p-value: p=<0.01
The K allele of the ICAM-1 K469E polymorphism is an independent risk factor for ACS recurrence and cardiovascular mortality, though this risk may be modulated by hypertension and HDL-C levels.
May flag higher-risk ACS patients for closer monitoring; leaves open validation and clinical utility of ICAM-1 genotyping.
OBJECTIVE: To explore the relation between K469E gene polymorphism of intercellular adhesion molecular-1 (ICAM-1) and the recurrence of ACS and cardiovascular mortality. METHODS: A total of 185 patients with ACS hospitalized in Department of Cardiology in our hospital from Sep 2007 to Sep 2008 were selected as objectives. Polymerase chain reaction was used to analyze K469E gene polymorphism of ICAM-1. According to the genotypes, they were divided into two groups: group with K allele (KK+KE) and group without K allele (EE). The two groups were followed up prospectively for five years and blood lipid, blood pressure, blood glucose, recurrence and death of ACS were collected when the patients left hospital. The relation between ICAM-1 gene polymorphism and the recurrence of ACS and cardiovascular mortality was analyzed by Logistic regression. RESULTS: After long-term follow-up, it was found that ACS recurred on 71 cases (38.4%) and 10 cases died, among which 3 cases died of cardiovascular disease. The recurrence of ACS and cardiovascular mortality in group with K allele were remarkably higher than that in group without K allele (P<0.01). After multivariate Logistic regression adjusted ages, gender, weight indexes, TC, LDL-C, TG, smoking, drinking, family history of cardiovascular disease, history of hypertension and the severity of coronary artery disease, the risks of ACS recurrence and cardiovascular mortality in group with genotype KK+KE was 3.31 and 3.53 times of those in group with genotype EE respectively (P<0.01). When the independent variable of hypertension was introduced in regression analysis, the risks of ACS recurrence and cardiovascular mortality in group with K allele both decreased (P<0.05). When the independent variable of HDL-C was introduced, different genotypes of ICAM-1 weren't relevant with ACS recurrence and cardiovascular mortality (P>0.05). CONCLUSIONS: K469E gene polymorphism of ICAM-1 was related to ACS recurrence and cardiovascular mortality, K allele probably an independent risky factor and hypertension and to which the level of HDL-C were closely related.
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L et al. (2013) conducted a cohort in Acute Coronary Syndrome (ACS) (n=185). K allele (KK+KE) of ICAM-1 K469E polymorphism vs. Without K allele (EE genotype) was evaluated on ACS recurrence (OR 3.31, p=<0.01). The K allele of the ICAM-1 K469E polymorphism was associated with increased risks of ACS recurrence (OR 3.31) and cardiovascular mortality (OR 3.53) compared to the EE genotype (P<0.01).
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