Abstract 12619: Fibrinogen is an Independent Predictor of Coronary Artery Disease in Patients With Hypertension: Susceptibility for the Role of Fibrinogen Genetic Variability
Background: Studies have reported that hypertension (HTN) is related to increased inflammatory and coagulation process. In the present study we examined whether the rs180070 and rs2070011 polymorphisms of fibrinogen gene could affect the risk of coronary artery disease (CAD) in hypertensive patients via their effects on the aforementioned processes.
Methods: Our population consisted of 332 HTN and 412 nonHTN subjects with symptoms of stable angina pectoris. The two polymorphisms were determined by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique. Circulating levels of fibrinogen, interleukin-6 (IL-6), D-dimer and factors V, X activity were also measured with appropriate methods.
Results: The presence of A allele of rs180070 was associated with significantly high levels of fibrinogen in HTN (433.36±10.9 vs 405.7±8.8, p=0.05). In multivariable analysis, AA homozygosity of rs180070 (β(SE): 0.257 (18.6), p≤0.001), but not HTN status (β(SE): 0.05 (11.9), p=0.29) were independent predictors of fibrinogen levels. In hypertensive patients, higher fibrinogen levels >443 mg/dl [OR: 3.5, 95% CI (1.14-10.9, p=0.029), but not the AA genotype of rs180070 [OR: 3, 95% CI (0.78-11.9, p=0.11)] were independent predictors of CAD. Moreover, IL-6 levels were higher in AA homozygotes of the rs180070 compared to all other genotypes (AG or GG) (4.96±0.69 vs 3.7±0.2, p=0.046). Indeed, this genotype was the only adjusted independent predictor of IL-6 levels [β(SE): 0.151 (0.642), P = 0.032]. Also, it was associated with higher D-dimer levels in HTN compared to the G allele carriers (623.3±79.6 vs 388.6±23.5, p=0.048). The presence of the rs180070 or rs2070011 polymorphisms did not modify the activity of factors V, X (p=NS for all).
Conclusions: We have found that the AA genotype (rs180070), but not the HTN status, is a strong predictor of fibrinogen levels. Importantly, fibrinogen levels remain the only independent predictor of CAD in HTN patients admitted for symptoms of stable angina pectoris, despite the fact that the AA homozygosity (rs180070) modifies both the prothrombotic and the inflammatory profile in this cohort.
- © 2013 by American Heart Association, Inc.