Abstract 13027: The Effect of the COX-2 -765G>C SNP on Atherothrombotic Events in Patients Discharged After a First Acute Coronary Syndrome: a Prospective Long-Term Follow-Up Study
Background Multiple single nucleotide polymorphisms (SNPs) in the gene encoding for cyclooxygenase-2 (COX-2) have been identified. The COX-2 -765G>C SNP has been associated with decreased COX-2 expression and with significantly lower odds of a first atherothrombotic event. Our aim was to investigate the effect of the COX-2 -765G>C SNP on recurrent atherothrombotic events in a population discharged after a first acute coronary syndrome (ACS).
Methods Consecutive patients without a history of atherothrombotic events hospitalized between Apr 2002 and Jan 2004 with ACS were genotyped for the COX-2 -765G>C SNP. Follow-up ended in July 2008. We dichotomized the population according to genotype: one group of patients with the -765GG genotype and one group with the -765GC/CC genotypes. The primary endpoint was a composite of cardiovascular death, myocardial infarction and/or stroke. Multivariate analysis was performed.
Results The total population comprises a cohort of 260 patients discharged after a first ACS. The median age was 63 yrs (IQR 52-72 yrs) and 66% of the patients were male. Baseline characteristics were well-balanced between genotype groups. Genotyping for the -765G>C showed frequencies of 73% GG, 26% GC and 1% CC. The median duration of follow-up was 2.5 yrs (IQR 1.9-3.3 yrs). The primary endpoint occurred in 42 patients (16%). The event rate for the primary endpoint was 6.7 events per 100 patient years. The unadjusted hazard ratio for the -765GC/CC genotypes was 1.10 (95% CI 0.56-2.15, p=0.79) compared with -765GG. After adjustment, the hazard ratio was 0.95 (95% CI 0.48-1.87, p=0.88).
Conclusions In contrast to the protective effect of the COX-2 -765G>C SNP on first atherothrombotic events this effect could not be repeated in the present study with regard to recurrent events. These data suggest that once plaque rupture has resulted in an acute event, the prognostic impact of COX-2 may be less important than conventional risk factors.
- © 2012 by American Heart Association, Inc.