Platelet gene polymorphisms and risk of bleeding in patients undergoing elective coronary angiography: A genetic substudy of the PRAGUE-8 trial

Authors

MOTOVSKÁ Zuzana KVASNIČKA Jan HÁJKOVÁ Jaroslava KALA Petr ŠIMEK Stanislav BOBČIKOVÁ Petra PETR Robert BÍLKOVÁ Dana POLOCZEK Martin MIKLÍK Roman FISCHEROVÁ Michaela MALÝ Marek WIDIMSKÝ Petr

Year of publication 2010
Type Article in Periodical
Magazine / Source Atherosclerosis
MU Faculty or unit

Faculty of Medicine

Citation
Doi http://dx.doi.org/10.1016/j.atherosclerosis.2010.07.006
Field Oncology and hematology
Keywords Elective coronary angiography; Bleeding complications; Single nucleotide polymorphism; Platelet polymorphisms
Description Utilization of cardiac catheterization has increased dramatically over time. Bleeding is a major prognostic predictor after percutaneous coronary catheterization procedures. This study aimed to assess the impact of eight polymorphisms of genes encoding platelet receptors and enzymes on the risk of bleeding in patients undergoing elective coronary angiography (CAG). Methods: Polymorphisms of platelet receptors, GP Ia (807C>T, rs1126643), GP VI (13254T>C, rs1613662), GP IIIa (HPA-1, rs5918), PAR-1 (IVS-14A>T, rs168753), P2Y(12) (34C>T, rs6785930 and H1/H2 haplotype, rs2046934), and genetic variations of the gene coding for cyclooxygenase-1 (COX-1) (-842A>G, rs10306114 and 50C>T, rs3842787) were studied. The frequencies of gene polymorphisms carriers were investigated in 696 patients undergoing elective CAG because of suspected or proven stable coronary artery disease. Genotyping was done using PCR, followed by melting curve analysis with specific fluorescent hybridization probes. Results: In patients undergoing elective CAG (without ad hoc percutaneous coronary intervention (PCI) and without clopidogrel pretreatment) a significant association was found between bleeding risk and variations in the gene coding for COX-1 (-842A>G and 50C>T) (both p = 0.013). Six other investigated polymorphisms did not show any influence on bleeding complications. After controlling for potential bleeding confounders, the association between COX-1 gene polymorphisms (-842A>G and 50C>T) and bleeding risk remained statistically significant (both odds ratios 12.1, p = 0.012). Conclusion: Cyclooxygenase-1 -842G and 50T alleles significantly contribute to the risk of bleeding complications in patients undergoing elective CAG. Genetic testing is able to influence the safety of diagnostic cardiac catheterization in large numbers of low risk patients with borderline indications.

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