IL-10 GENE POLYMORPHISM AND STROKE RISK IN PATIENTS WITH CORONARY ARTERY DISEASE. (June 2018) - Minushkina, L.
Abstract : Objective: The purpose of our work was to analyze the possible association of clinical and genetic factors with the development of strokes in patients with coronary heart disease. Design and method: We included in to the study 1193 patients with acute coronary syndrome (63, 2% men, mean age 61, 1 ± 0, 34 yaers). 81, 5% of patients had essential hypertension, 14, 6% - diabetes, 38, 5% were smokers, 16, 4% had anamnesis of atrial fibrillation. Follow up was started on day 10 of stable state after index event. Inclusion into the study was performed in 2004–2007. Mean duration of follow up was 664, 9 days, maximum - 1999 days. To determine the allele and genotype of polymorphic markers of candidate genes isolation of genomic DNA from the venous blood was performed by the method of phenol-chloroform extraction. Polymorphisms of ApoB, FGB, PROC, CRP, IL-6, IL-10, TNF, LTA and KIF6 were detected by PCR. Results: A total of 37 strokes occurred during the follow-up period (3.1%), 17 (45.9%) were fatal, and 20 (54.1%) were nonfatal. The shortest period before the development of a stroke from inclusion of a patient into the study was 22 days, the largest - 1433 days, the average - 389 ± 56.6 days. Patients who were observed to have strokes were older, had a history of CHD prior to index event, were more likely to have high BP level, more likely to have recurrent MI, or repeated episodes of severe ischemia and atrial fibrillation during hospitalization, they had a lower GFR. Patients who observed stroke development were less likely to get statins (46.5% of cases compared to 64.9% of cases, p = 0.021) and antithrombotic (81.1% vs. 93.3%, p = 0.004) therapy. Only carriage of A allele of G (-1082)A polymorphism of IL-10 gene was associated with risk of stroke: OR 1, 54 [1, 02–2, 65], p = 0, 043. Conclusions: Multifactorial Cox analysis showed that carriage of A allele of IL-10 gene, high BP level, history of MI, recurrent severe ischemia and atrial fibrillation during index hospitalization and absent of antithrombotic therapy were independently associated with stroke risk.