EVALUATION OF PROGNOSTIC SIGNIFICANCE OF GNβ3:825, NOS3:786 AND NOS3:894 POLYMORPHISMS IN PATIENTS WITH METABOLIC SYNDROME UNDERGOING PERCUTANEOUS CORONARY INTERVENTION FOR ACUTE CORONARY SYNDROME WITHOUT PERSISTENT ST-SEGMENT ELEVATION

Objective: to evaluate the prognostic significance of GNβ3:825, NOS3:786 and NOS3:894 polymorphisms for acquisition of acute coronary syndrome in patients without persistent ST-segment elevation (ACS without ST) with a potential metabolic syndrome (MS) and subsequent cardiovascular prognosis after percutaneous coronary intervention (PCI).

Materials and methods. We examined the polymorphism C825T gene β3-subunit of G protein, T786S NOS3 gene and G894T NOS3 gene in 99 patients of the main group with MS, who was admitted for the purpose of PCI for ACS without ST, and 51 people of the control group (with MS, but without coronary artery disease (by PCI). The groups were comparable in age and sex.

Results. The distribution of genotypes for all selected genes in both groups meet Hardy-Weinberg equilibrium. Among the patients observed with MS from Odessa and Odessa region, ACS without ST has greater prevalence in patients with T/T (φ=0.156, p<0.05, χ2=2.62) and C/T (φ=0.156, p<0.05, χ2=3.650) polymorphism GNβ3:825 and C/C polymorphism NOS3:786 (φ=0.216, p<0.05, χ2=7.312). Instead, G/G polymorphism NOS:894 can be regarded as a reliable (φ=0.26, p<0.01, χ2=10.3) protective factor on the occurrence of ACS without ST with MS.

Patients with MS and T/T polymorphism GNβ3:825 significantly (φ=0.249, p<0.05, χ2=4.306) more after PCI (surveillance period (14.76±0.20) months (11–19 months)) for ACS without ST have had a “cumulative point of adverse events” (cardiovascular death, recurrent cases of ACS, revascularization, restenosis/rethrombosis of stent, hospitalization for congestive heart failure).

Conclusions: T/T and C/T polymorphism gene GNβ3:825 and C/C gene polymorphism NOS3:786 requires personalized approach as for the timing and aggression of the primary prevention, correction of modifying factors and drug therapy. T/T polymorphism GNβ3:825 in patients with MS after PCI for ACS without ST needs more attentive tactics from medical staff in stage of inpatient and outpatient treatment.