Abstract 14193: Genetic Polymorphisms Associated with Coronary Artery Disease in Patients with Previous Low Cardiovascular Risk, Assessed by Traditional Risk Factors

Abstract

Several studies have attempted to link genetic polymorphisms with coronary artery disease (CAD) onset. The risk of each polymorphism is lower (OR=1.1 or 1.2) than that associated with traditional risk factors (TRF). These factors may be controlled by effective intervention measures. Therefore, it becomes important to understand the cause of vascular disease, in patients without TRF factors and try to assess the associated genetic factors.

Aims: Evaluate the genetic factors associated with vascular disease development in patients without TRF. Methods: Case-control study that included 1032 individuals, 195 coronary patients consecutively admitted to hospital without major cardiovascular risk factors (smoking, diabetes, hypertension or severe dyslipidemia), mean age 54.9 years, 67.7% male and 837 controls without CAD, mean age 54.6 years, 71% male. Cases and controls were gender and age matched. We evaluated 16 genetic variants previously associated with CAD. We analyzed the Hardy-Weinberg equilibrium and the genotype CAD risk was determined using a bivariate (tables 3x2 with OR and 95% CI) and multivariate analysis.

Results: In patients with low cardiovascular risk, only three polymorphisms, namely: PCSK9 AA (OR=1.94, p=0.011); 9p21 rs1333049 CC (OR=1.49, p= 0.017) and PON55 MM (OR=1.49, p=0.050) have shown an increased CAD risk. After logistic regression, these polymorphisms remained highly significant for CAD, in low risk patients. The wild genotype appears to be protective. On the other hand, the polymorphism normally associated with CAD, ACE DD, showed no association with CAD, suggesting that its mechanism of action may depend on the TRF.

Conclusions: The present study discloses some polymorphic variants associated with the coronary disease risk, in patients without major traditional risk factors and, apparently, low risk. In these really high risk patients, it will be important, in the future, to define early intervention preventive programs.