Clinical and prognostic significance of NOS3 and APOE gene variants in patients with unstable angina pectoris
Abstract. The development of personalized medicine is associated with the study of genetic polymorphisms that determine the predisposition to cardiovascular diseases.Dadova M.S., Kostenko V.A., Skorodumova E.A., Rysev A.V., Pivovarova L.P., Ariskina O.B., Siverina A.V., Skorodumova E.G., Koroleva M.I.
The aim: to assess the impact of APOE, NOS3 gene polymorphisms at the clinical course and prognosis (12 months) of patients with unstable angina pectoris (UAP).
Material and methods. Case histories and examination data of 100 patients with UAP treated at I.I. Dzhanelidze Saint Petersburg research institute of emergency care from 2022 to 2024 were studied. The remote results after 12 months were assessed: frequency of rehospitalizations for acute coronary syndrome (ACS), paroxysmal atrial fibrillation (AF), decompensations of chronic heart failure and acute cerebrovascular accident. Genetic testing of APOE, NOS3 was performed with division of the participants into 2 groups depending on the NOS3 gene polymorphism (T786C): Group 1 (n = 42) – CC/TC genotypes, Group 2 (n = 58) – TT genotype. The age and gender of patients were comparable in both groups.
Results. The frequency of occurrence of NOS3 gene variants in the general group was as follows: CC – in 4%, TC – in 38%, TT – in 58% of patients. Distribution by the APOE gene: LeuLeu in 75% of participants, the rest – heterozygous LeuPro. TC/CC NOS3 carriers were more likely to have had myocardial infarction and percutaneous coronary intervention in the past, more severe coronary artery disease, worsening of chronic renal disease and high levels of C-reactive protein, indicating a pronounced systemic inflammatory response. LeuPro APOE carriers were found to have elevated levels of total cholesterol, low-density lipoproteins in the blood and a higher frequency of multifocal atherosclerosis. Patients with the TC/CC NOS3 genotype had an increased risk of recurrent ACS and paroxysmal AF within a year.
Conclusion. Genotypes CC and TC NOS3 are associated with severe clinical course of the disease and evident systemic inflammation. Genotype TC/CC NOS3 increases the risk of recurrent ACS and AF within a year. Polygenic carriage of recessive alleles of the NOS3 and APOE genes worsens the prognosis of patients in short- and long-term perspective.
Keywords
unstable angina pectoris
long-term prognosis
gene polymorphism
NOS3
APOE
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About the Authors
Marianna S. Dadova, MD, postgraduate seeker for the degree of PhD (Medicine) at I.I. Dzhanelidze Saint Petersburg Research Institute of Emergency Care, cardiologist at Saint Petersburg City Consultative and Diagnostic Center No. 1. Address: 192242, Saint Petersburg, 3, litera A Budapestskaya St.E-mail: dadova78@gmail.com
ORCID: https://orcid.org/0009-0009-3922-1971. eLibrary SPIN: 8709-6885
Victor A. Kostenko, MD, Dr. Sci. (Medicine), head of the Department of emergency cardiology and rheumatology, I.I. Dzhanelidze Saint Petersburg Research Institute of Emergency Care. Address: 192242, Saint Petersburg, 3, litera A Budapestskaya St.
E-mail: vic2012tor@mail.ru
ORCID: https://orcid.org/0000-0002-7015-1010. eLibrary SPIN: 2774-0835
Elena A. Skorodumova, MD, Dr. Sci. (Medicine), leading researcher at the Department of emergency cardiology and rheumatology, I.I. Dzhanelidze Saint Petersburg Research Institute of Emergency Care. Address: 192242, Saint Petersburg, 3, litera A Budapestskaya St.
E-mail: elskor@mail.ru
ORCID: https://orcid.org/0000-0002-5017-0214. eLibrary SPIN: 6393-1178
Alexander V. Rysev, MD, PhD (Medicine), associate professor, deputy chief physician for therapy, I.I. Dzhanelidze Saint Petersburg Research Institute of Emergency Care. Address: 192242, Saint Petersburg, 3, litera A Budapestskaya St.
E-mail: 79213221618@yandex.ru
ORCID: https://orcid.org/0000-0001-8261-2438. eLibrary SPIN: 7715-0455
Lyudmila P. Pivovarova, MD, Dr. Sci. (Medicine), head of the Department of laboratory diagnostics, I.I. Dzhanelidze Saint Petersburg Research Institute of Emergency Care. Address: 192242, Saint Petersburg, 3, litera A Budapestskaya St.
E-mail: pivovaroval@yandex.ru
ORCID: https://orcid.org/0000-0002-9492-4516. eLibrary SPIN: 2832-3106
Olga B. Ariskina, PhD (Biology), researcher at the Department of laboratory diagnostics, I.I. Dzhanelidze Saint Petersburg Research Institute of Emergency Care. Address: 192242, Saint Petersburg, 3, litera A Budapestskaya St.
E-mail: olga.ariskina@mail.ru
ORCID: https://orcid.org/0000-0001-6311-1259. eLibrary SPIN: 6067-8268
Anna V. Siverina, MD, PhD (Medicine), researcher at the Department of emergency cardiology and rheumatology, I.I. Dzhanelidze Saint Petersburg Research Institute of Emergency Care. Address: 192242, Saint Petersburg, 3, litera A Budapestskaya St.
E-mail: gudkovanna_09@mail.ru
ORCID: https://orcid.org/0000-0002-6831-2153. eLibrary SPIN: 7817-1246
Elizaveta G. Skorodumova, MD, PhD Medicine), junior researcher at the Department of emergency cardiology and rheumatology, I.I. Dzhanelidze Saint Petersburg Research Institute of Emergency Care. Address: 192242, Saint Petersburg, 3, litera A Budapestskaya St.
E-mail: lisavetta91@mail.ru
ORCID: https://orcid.org/0000-00024961-5570. eLibrary SPIN: 3403-2138
Maria I. Koroleva, MD, head of the Department of cardiology, cardiologist at Saint Petersburg City Consultative and Diagnostic Center No. 1. Address: 194354, Saint Petersburg, 10 Seikerosa St.
E-mail: bizeshka92@mail.ru
ORCID: https://orcid.org/0009-0003-4687-1661
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