CLINICAL-GENETIC RISKOMETER FOR THE ISCHEMIC STROKE RISK ASSESSMENT IN ATRIAL FIBRILLATION
https://doi.org/10.15829/1560-4071-2015-10-42-45
Abstract
Aim. To assess genetic issues in the ischemic stroke development in AF and to invent an analytical programmed complex for genetic risk estimation of stroke development in a patient with AF.
Material and methods. Totally 43 patients studied with AF and stroke in anamnesis, 78 — with AF and no stroke. Controls consisted of 188 persons without cardiovascular pathology. The participants underwent ECG, EchoCG, Holter ECG-monitoring, exercise test, TELAS, thyroid gland hormones analysis. For confirmation of the ischemic nature of stroke in participating probands we performed computed tomography of the brain. All participants also underwent molecular genetic testing.
Results. According to the odds ratio, allele A polymorphism -455G>A of gene FGB increases the risk of ischemic stroke development in atrial fibrillation 1,7 times comparing to those patients without the allele; genotypes with the rare T allele in homoand heterozygous state of polymorphism 807С>Т of gene GPI? increases 2,5 times the risk of stroke in AF; presence of allele C polymorphism -5Т>С of gene GPI?? increases 1,9 times the risk of stroke comparing to its absence; presence of the rare genotypes allele C in homoand heterozygous state -5Т>С of gene GPI?? increases 2,3 times stroke risk; allele A of the polymorphism 10976G>A gene FVII decreases the risk of stroke 2,6 times. According to the results, there was a “Clinical-genetic riskometer of the ischemic stroke in AF” developed. Using this informational-analytic complex it is possible to estimate genetic risk of the stroke.
Conclusion. Therefore, the study has shown that homozygous genotype AA of the rare polymorphism 455G>A gene FGB, heterozygous genotype СТ and homozygous genotype ТТ of the rare polymorphism allele 807С>Т gene GPI?, heterozygous genotype TC and homozygous genotype CC by the rare allele polymorphism -5Т>С gene GPI?? are defined as genetic predictors of ischemic stroke development in atrial fibrillation. Allele А of polymorphism 10976G>A gene FVII is protective against ischemic stroke in patients with AF. Knowing the parameters of genetic assessment in AF, it is possible to calculate genetic risk of ischemic stroke development in AF via invented by us a “Clinical-Genetic riskometer of ischemic stroke in AF”.
About the Authors
N. V. AksyutinaRussian Federation
V. A. Shulman
Russian Federation
S. Yu. Nikulina
Russian Federation
B. V. Nazarov
Russian Federation
V. N. Maksimov
Russian Federation
Competing Interests: Доктор медицинских наук, зав. лабораторией молекулярно-генетических исследований
E. V. Plita
Russian Federation
M. Yu. Kotlovsky
Russian Federation
T. D. Vereshchagina
Russian Federation
References
1. Diagnostics and treatment of fibrillation of auricles. RCS, ARSA and ACVS recommendations. Russ J Cardiol. 2013; 4: Suppl. 3. Russian (Диагностика и лечение фибрилляции предсердий. Рекомендации РКО, ВНОА и АССХ. Российский кардиологический журнал 2013, 4: приложение 3).
2. Tarzimanova AI, Fomina YG. Cardiovascular therapy and prevention. M.: Medicine; 2006. Russian (Тарзиманова А. И., Фомина Ю. Г. Кардиоваскулярная терапия и профилактика. М.: Медицина, 2006).
3. Roldan V, Marin F, Gonzalez-Conejero R, et al. Factor VII-323 decanucleotide D/I polymorphism in atrial fibrillation: Implications for the prothrombotic state and stroke risk. Ann. Med. 2008; 40, 7: 553-9.
4. Gretarsdottir S, Thorleifsson G, Manolescu A, et al. Risk variants for atrial fibrillation on chromosome 4q25 associate with ischemic stroke. Ann. Neurol.2008; 64, 4: 402-9.
5. Wnuk M, Pera J, Jagie??a J, et al. The rs2200733 variant on chromosome 4q25 is a risk factor for cardioembolic stroke related to atrial fibrillation in Polish patients. Neurol. Neurochir. Pol. 2011; 45, 2: 148-52.
6. Lemmens R, Buysschaert I, Geelen V, et al. The association of the 4q25 susceptibility variant for atrial fibrillation with stroke is limited to stroke of cardioembolic etiology. Stroke 2010; 41, 9: 1850-7.
7. Gudbjartsson DF, Holm H, Gretarsdottir S, et al. A sequence variant in ZFHX3 on 16q22 associates with atrial fibrillation and ischemic stroke. Nat. Genet. 2009; 41: 876-8.
8. Gilyarov M. Yu. Thromboembolic events in patients with atrial fibrillation: the factors influencing the risk of their development and the effectiveness of antithrombotic therapy: Dis. ... Dr. med. sciences: 14.01.05. M., 2011. 45 p. Russian (Гиляров М. Ю. Тромбоэмболические осложнения у больных с фибрилляцией предсердий: факторы, влияющие на риск их развития и эффективность антитромботической терапии : автореф. дис. … д-ра мед. наук : 14.01.05. Гиляров Михаил Юрьевич. М., 2011. 45 с.).
Review
For citations:
Aksyutina N.V., Shulman V.A., Nikulina S.Yu., Nazarov B.V., Maksimov V.N., Plita E.V., Kotlovsky M.Yu., Vereshchagina T.D. CLINICAL-GENETIC RISKOMETER FOR THE ISCHEMIC STROKE RISK ASSESSMENT IN ATRIAL FIBRILLATION. Russian Journal of Cardiology. 2015;(10):42-45. (In Russ.) https://doi.org/10.15829/1560-4071-2015-10-42-45