Utilization of cardiac catheterization increased dramatically over time. Bleeding is a major prognostic predictor after percutaneous coronary catheterization procedures. This study aimed to assess the impact of 10 polymorphisms of genes encoding platelet receptors, enzymes, and haemostatic factors on risk of bleeding in patients undergoing elective coronary angiography (CAG).
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), P2Y12 (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 investigated. Mutations in the genes coding for coagulation factor V (Q506R (Leiden) mutation, rs6025) and factor II (prothrombin G20210A, rs1799963) were also studied. The prevalence of gene polymorphisms was 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.
In patients undergoing elective CAG (without ad hoc PCI and without clopidogrel pretreatment) a significant association was found between bleeding risk and genetic variations of the gene coding for COX-1 (−842A>G and 50C>T) (p = 0.0133 and p=0.0138 resp.). Eight other investigated polymorphisms did not show any influence on bleeding complications (table). In logistic regression, which took other known bleeding risk factors into account, the significance of the COX-1 gene polymorphisms (−842A>G and 50C>T) and bleeding risk has been suggested (p = 0.032 and p = 0.036 resp.).
Cyclooxygenase-1 −842G and 50T alleles significantly contribute to the risk for bleeding complications in patients undergoing elective CAG.
Genetic testing is able to influence safety of diagnostic cardiac catheterization in large numbers of low risk patients with borderline indications.
Zuzana Motovska, No Financial Disclosure Information; No Product/Research Disclosure Information