russjcardiolРоссийский кардиологический журналRussian Journal of Cardiology1560-40712618-7620«SILICEA-POLIGRAF» LLC10.15829/1560-4071-2014-10-7-12russjcardiol-27Research ArticleКАРДИОГЕНЕТИКАCARDIOGENETICИСПОЛЬЗОВАНИЕ ГЕНЕТИЧЕСКИХ МАРКЕРОВ ИШЕМИЧЕСКОЙ БОЛЕЗНИ СЕРДЦА В КЛИНИЧЕСКОЙ ПРАКТИКЕ: РЕАЛЬНОСТЬ ИЛИ ОТДАЛЕННАЯ ПЕРСПЕКТИВА?CLINICAL SIGNIFICANCE OF CORONARY ARTERY DISEASE GENETIC MARKERS: REALITY OR FAR FUTURE?ШестерняП. А.ShesternyaP. A.

Кандидат медицинских наук, доцент кафедры внутренних болезней №1

shesternya75@mail.ruШульманВ. А.NikulinaS. Yu.

Доктор медицинских наук,  профессор  кафедры внутренних  болезней  №1

shesternya75@mail.ruНикулинаС. Ю.ShulmanV. A.

Доктор медицинских наук, профессор, заведующая кафедрой  внутренних болезней №1,  проректор   по  УР

shesternya75@mail.ruСергееваА. С.SergeevaA. S.

Ассистент   кафедры   кардиологии и функциональной диагностики ИПО

shesternya75@mail.ruДемкинаА. И.DemkinaA. I.

Аспирант кафедры внутренних болезней №1

shesternya75@mail.ruМаксимовВ. Н.MaksimovV. N.

Доктор медицинских наук,  заведующий.  лабораторией молекулярно-генетических    исследований   терапевтических    заболеваний

shesternya75@mail.ruВоеводаМ. И.VoevodaМ. I.

Доктор медицинских наук, профессор, член-корреспондент РАМН, директор

shesternya75@mail.ruКрасноярский государственный медицинский университет имени профессора В. Ф. Войно-Ясенецкого Минздрава РФРоссияKrasnoyarsk State Medical University n. a. prof. Voino-YasenetskyRussian FederationНИИ терапии и профилактической медицины СО РАМН, НовосибирскРоссияScientific Research Institute for Therapy and Preventive Medicine of the SB RAMS, NovosibirskRussian Federation201428102014010712Copyright © Шестерня П.А., Шульман В.А., Никулина С.Ю., Сергеева А.С., Демкина А.И., Максимов В.Н., Воевода М.И., 20142014Шестерня П.А., Шульман В.А., Никулина С.Ю., Сергеева А.С., Демкина А.И., Максимов В.Н., Воевода М.И.Shesternya P.A., Nikulina S.Y., Shulman V.A., Sergeeva A.S., Demkina A.I., Maksimov V.N., Voevoda М.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://russjcardiol.elpub.ru/jour/article/view/27

Цель. Оценить возможность клинического применения данных генотипирования локуса 9р21.3 у больных ИМ.Материал и методы. В исследование включено 500 больных ИМ в возрасте ≤65 лет [Ме 54,0; Q25 48,0; 59,0], в т. ч. 411 (82,2%) мужчин и 89(17,8%) женщин, и данные 31 аутопсии — 24 мужчин и 7 женщин в возрасте ≤65 лет (57,87±5,92 лет) с верифицированным ИМ, как причиной смерти. Группа контроля состояла из 423 (79,1%) мужчин и 112 (20,9%) женщин в возрасте ≤65 лет [Ме 55,0; Q25 48,0; Q75 61,0) с исключенной ИБС. Период проспективного наблюдения после ИМ составил 2 года. Выделение ДНК проводилось методом фенол-хлороформной экстракции из венозной крови или ткани миокарда. Для генотипирования были выбраны два однонуклеотидных полиморфизма (ОНП) rs1333049 и rs10757278 локуса 9р21.3.Результаты. В логистической регрессионной модели продемонстрировано самостоятельное предикторное значение генотипа СС rs1333049 в развитии ИМ — ОШ=1,71 [95% ДИ: 1,16-2,52], р=0,006. Выявлена ассоциация аллеля С rs1333049 с частотой повторного острого коронарного синдрома (ОКС) в отдаленный период наблюдения (6, 12, 24 месяцев) у больных ИМ, не подвергавшихся чрескожному коронарному вмешательству (ЧКВ) в стационаре. В течение первого года после выписки из стационара носители аллеля риска С rs1333049 имели риск повторного ОКС — ОШ=4,91 [95% ДИ: 1,45-16,66], через два года наблюдения — ОШ=3,77 [95% ДИ: 1,50-9,52].Заключение. Предложено практическое использование генотипа rs1333049 для прогнозирования развития ИМ и отдаленных исходов заболевания.

Aim. The purpose of this study was to access clinical application of the 9p21.3 locusgenotype in patients with myocardial infarction (MI).Material and methods. Totally 500 (411 male, 89 female) patients with MI youngerthan 65 years old [Ме 54,0; Q25 48,0; Q 59,0] and 31 autopsy data (24 male,7 female) in case of fatal MI were collected. All participants were included in the 75study after written informed consent form. Control group consisted of 535 participants (423 male, 112 female) without coronary artery disease [Ме 42,6;Q25 39,0; Q 44,3]. Genome DNA was extracted from venous blood or myocardialtissue using the phenol-chloroform extraction method. Two SNPs rs10757278 andrs1333049 (locus 9p21.3) were tested. Prospective follow-up period lasted 2 years.Results. We revealed a direct strong association of the locus 9р21.3 (rs1333049)with MI. Logistic regression odds ratio (OR) of MI for homozygous genotype CCrs1333049 was 1,71 [95% CI: 1,16-2,52], р=0,006. In patient who didn’t underwent PCI and carried of risk allele C rs1333049 had significant higher risk of recurrent 75acute coronary syndrome (ACS): during 1 year after MI – OR=4,91 [95% CI: 1,4516,66];during2yearafterMI–OR=3,77[95%CI:1,50-9,52].Conclusion.We suppose these data might be effectively utilized for improvement of onset of MI and long-term outcome prognosis.

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The authors declare that there are no conflicts of interest present.