Authors: Giuseppe Patti Carolina Fossati Annunziata Nusca Simona Mega Vincenzo Pasceri Andrea D’Ambrosio Barbara Giannetti Ombretta Annibali Giuseppe Avvisati Germano Di Sciascio
Publish Date: 2008/06/25
Volume: 27, Issue: 4, Pages: 413-420
Abstract
In patients with acute myocardial infarction AMI a persistently occluded infarctrelated artery IRA is associated with unfavorable prognosis and genetic factors may be contributing factors to thrombolysis failure Onehundred and one consecutive patients treated with intravenous thrombolysis during AMI were blindtested for methylenetetrahydrofolate reductase MTHFR and circulating homocysteine levels and underwent protocol angiography 14 ± 6 days after the event IRA was patent in 61 patients and occluded in 40 Overall MTHFR 677TT frequency was 22 Patients with MTHFR 677TT homozygosis had higher prevalence of occluded IRA 73 versus those with MTHFR 677CT/CC genotype 30 P 0001 MTHFR 677TT genotype predicted independently the risk of IRA occlusion with a specificity of 90 odds ratio 38 95 confidence interval 11–91 P = 003 Moreover patients with occluded IRA and MTHFR 677TT genotype had the highest homocysteine levels 21 ± 76 μmol/l vs ≤149 ± 38 μmol/l P = 0011 In patients with AMI MTHFR 677TT homozygosis is independently associated with a persistently occluded IRA after thrombolysis This finding may have pathophysiological and therapeutic implications for recanalization strategies in patients with AMI
Keywords: