Aim: to analyze the prognostic value of gene polymorphisms ACE (D/I), SLCO1B1 (Val174Ala), LIPC (C514T), CYP2C19*2, CYP2C19*3, ADRB1 (Ser49Gly), ADRB1 (Arg389Gly) of patients with ST-segment elevation myocardial infarction (STEMI). Materials and methods: 145 patients with STEMI from 45 to 75 years of age were involved into the study. All patients were prescribed all recommended preparations improving prognosis (statins, angiotensin-converting enzyme inhibitors, beta-blockers, clopidogrel as part of dual antiplatelet therapy) from the first day of hospitalization. To determine gene polimorphismspolimerase chain reactionwas used. Prognosis was assessed by a combined endpoint, including cardiovascular mortality, nonfatal myocardial infarction, unplanned revascularization of coronary arteries and hospitalization for unstable angina, throughout 12 months. Results. The II genotype of the polymorphic gene ACE (I / D) is a predictor of the 12-month STEMI fa-vorable outcome. Allele Ser of the polymorphic gene ADRB1 Ser49Gly is associated with an increased incidence of adverse cardiovascular events within 12 months after STEMI. Gene polymorphisms SLCO1B1 (Val174Ala), CYP2C19*2, CYP2C19*3, ADRB1 (Arg389Gly), LIPC (C514T) does not affect the 12-month forecast after STEMI. Conclusions. Genotyping of ACE (I /D) and ADRB1 Ser49Gly can be used to assess the long-term prog-nosis and effectiveness of pharmacotherapy STEMI by means of personalizing it.
gene polymorphism, pharmacogenetics, the prognosis after myocardial infarction
1. Ambulatorno-poliklinicheskiy registr kardiovaskulyarnykh zabolevaniy v Ryazanskoy oblasti (REKVAZA): osnovnye zadachi, opyt sozdaniya i pervye rezul´taty / Boytsov S.A., Yakushin S.S., Martse-vich S.Yu., Luk´yanov M.M., Nikulina N.N., Zagrebel´nyy A.V. [i dr.]. Ratsional´naya farmakoterapiya v kardiologii. 2013. №9(1). S. 4-14.
2. Pereverzeva K.G., Vorob´ev A.N., Nikulina N.N., Moseychuk K.A., Pravkina E.A., Yakushin S.S. Osobennosti obsledovaniya patsientov s ishemicheskoy bolezn´yu serdtsa v ambulatornoy praktike po dannym registrovogo nablyudeniya. Rossiyskiy mediko-biologicheskiy vestnik im. akademika I.P. Pavlova. 2014. №1. S. 90-96.
3. Sychev D.A. Farmakogeneticheskoe testirovanie: klinicheskaya interpretatsiya rezul´tatov. Mo-skva, 2011. 303 s.
4. Boeva O.I. Kliniko-geneticheskaya model´ dvukhletnego prognoza u bol´nykh, perenesshikh epizod obostreniya ishemicheskoy bolezni serdtsa. Vestnik novykh meditsinskikh tekhnologiy. 2008. T. 15, №2. S. 68-70.
5. Boeva O.I., Shcheglova E.V. Vozmozhnosti prognozirovaniya neblagopriyatnogo iskhoda u bol´nykh, perenesshikh ostryy koronarnyy sindrom. Meditsinskiy vestnik Severnogo Kavkaza. 2007. №3. S. 19-23.
6. Genotypic interactions of renin-angiotensin system genes in myocardial infarction / Araujo M.A., Goulart L.R., Cordeiro E.R. [et al.]. Int J Cardiol. 2005. №103(1). R. 27-32.
7. Antman E.M., Hand M., Armstrong P.W. Focused Update of the ACC/AHA 2004 Guidelines for the Management of Patients with ST-Elevation Myocardial Infarction. J Am CollCardiol. 2008. №51. R. 210-247.
8. Magnusson Y., Levin M.C., Eggertsen R. Ser49Gly of beta1-adrenergic receptor is associated with ef-fective betablocker dose in dilated cardiomyopathy. Clin. Pharmacol. Ther. 2005. №78(3). R. 221-231.
9. Aleong R.G., Sauer W.H., Robertson A.D., Liggett S.B., Bristow M.R. Adrenergic receptor polymor-phisms and prevention of ventricular arrhythmias with bucindolol in patients with chronic heart failure. Circ. Arrhythm. Electrophysiol. 2013. №6(1). R. 137-143.
10. A novel polymorphism in the gene coding for the beta1-adrenergic receptor associated with survival in patients with heart failure / Borjesson M., Magnusson Y., Hjalmarson A. [et al.]. Eur Heart J. 2000. №21. R. 1853-1858.
