Association between AT C573T polymorphism and cardiovascular risk factors in myocardial infarction.

BACKGROUND: Polymorphisms in the AT1 gene have been associated with various parameters related to the pathogenesis of cardiovascular diseases and to myocardial infarction. This study analyzed the relationship between two polymorphisms of the angiotensin II AT-1 receptor gene (AT1_1166 and AT1_573) and the risk of ischemic heart disease by studying their association with several cardiovascular risk factors. METHODS: The sample population comprised 356 subjects: 174 patients who had survived myocardial infarction (61.01 ± 8.15 years), and 182 age- and gender-matched controls (mean age of 60.25 ± 9.43). The polymorphisms of the angiotensin II AT1-receptor gene (C573T and A1166C) were studied by polymerase chain reaction and DNA restriction analysis. We compared the patients' genetic polymorphism with their risk of ischemic heart disease. RESULTS: The A1166C polymorphism did not show any significant differences between the groups. However, with respect to C573T, genotypes tended to differ significantly between cases and controls in the CC and TT types, remaining significant when the CC and CT+TT were grouped. Through analysis of the fit of various multivariate models, we found that the CC genotype is a risk factor for myocardial infarction. This risk remains significant after being adjusted for gender, age, homeostasis model assessment, and anthropometric variables. CONCLUSIONS: There is a relationship between the C573T polymorphism and the pathogenesis of myocardial infarction that seems to be due to its relationship with some risk factors. However, given the multifactorial nature of this pathology, further studies are needed to confirm the evidence that we report herein.

[Metabolic syndrome in patients with coronary heart disease. Results of using different diagnostic criteria]. / Síndrome metabólico en pacientes con cardiopatía isquémica. Resultados obtenidos con la utilización de diferentes criterios.

A unified definition of metabolic syndrome, considered a common feature of cardiovascular risk, is lacking. The aim of this study was to compare the prevalence of this syndrome in patients with ischemic heart disease using two diagnostic criteria: the European Group of Resistance to Insulin and the National Cholesterol Education Program. We designed an observational, cross-sectional study of the factors that make up metabolic syndrome in subjects diagnosed with coronary heart disease. A total of 169 patients aged 35 to 79 years were studied (129 men and 40 women). With the European group criterion the percentage of patients with metabolic syndrome was 43.7%, whereas the American group criterion yielded a prevalence of 40.8% (no significant difference). The prevalence of metabolic syndrome among patients with ischemic heart disease is high. The diagnostic criteria used are similar and do not differ significantly, although diagnostic concordance was only 50%.

[Prevalence of metabolic syndrome in patients with coronary heart disease]. / Prevalencia del síndrome metabólico entre pacientes con cardiopatía isquémica.

BACKGROUND AND OBJECTIVE: We aimed to know the prevalence of classical cardiovascular risk factors, hyperinsulinism, insulin resistance and metabolic syndrome (MS) in a population with coronary heart disease (CHD) as compared with a population without personal or familial history of cardiovascular risk factors. SUBJECTS AND METHOD: This was an observational and transversal study of cardiovascular risk factors making up the MS in an adult population. 367 subjects aged 35-79 years (268 men and 99 women) were studied; 185 had CHD (141 men and 44 women) and 182 (127 men and 55 women) were included as a control population. 82 individuals of the control group who had no MS components were selected for the calculation of parameters of hyperinsulinism and the HOMA (Homeostasis Model Assessment) index in order to evaluate the insulin resistance. RESULTS: As compared with the control group, patients with CHD showed higher blood pressure (systolic and dyastolic), body mass index (BMI), triglicerydes and apo B100 concentrations, and lower HDL-c and apo A1 values. They also exhibited higher values of glycemia and insulinemia and consequently a higher HOMA index. The values of insulin and HOMA (percentil 75), obtained from the selected group for this purpose, were 12 U/ml and 3.03, respectively. In the CHD population, 38.28% (95% CI, 31.13-45.95) had hyperinsulinism, 47.02% (95% CI, 39.70-54.47) had insulin resistance (HOMA) and 41.08% (95% CI, 33.98-48.55) had MS. CONCLUSIONS: There was a high prevalence of cardiovascular risk factors in the CHD population. Patients with CHD have higher hyperinsulinism and insulin resistance as well as a greater prevalence of MS. Despite treatment, a clear association exists between MS and CHD in both men and women.

Prevalencia del síndrome metabólico entre pacientes con cardiopatía isquémica / Prevalence of metabolic syndrome in patients with coronary heart disease

FUNDAMENTO Y OBJETIVO: Conocer la prevalencia de los factores de riesgo cardiovascular clásicos -hiperinsulinismo, resistencia a la insulina y síndrome metabólico (SM)- en una población con cardiopatía isquémica (CI), comparándola con una población de control seleccionada sin antecedentes personales ni familiares de CI y con escasos factores de riesgo cardiovascular. SUJETOS Y MÉTODO: Se trata de un estudio observacional y transversal de los factores de riesgo cardiovascular integrantes del SM en población adulta. Estudiamos a 367 sujetos de entre 35 y 79 años de edad (268 varones y 99 mujeres); 185 presentaban CI (141 varones y 44 mujeres) y 182 (127 varones y 55 mujeres) fueron utilizados de población control. Del grupo control se seleccionó a 82 individuos sin ninguno de los componentes del SM para el cálculo de los parámetros de hiperinsulinismo y se empleó el índice HOMA (Homeostasis Model Assessment) para la evaluación de la resistencia a la insulina. RESULTADOS: Los pacientes con CI, comparados con el grupo control, presentaron de forma significativa mayor presión arterial (sistólica y diastólica), mayor índice de masa corporal (IMC), mayor valor de triglicéridos y Apo B100, con descensos de HDL y Apo A1. Los pacientes con CI presentaron mayores cifras de glucemia e insulinemia basales y, por consiguiente, fue superior el cálculo del HOMA. Los valores de insulina y HOMA (percentil 75) obtenidos del grupo seleccionado para este fin fueron de 12 µU/ml y 3,03, respectivamente. En la población con CI encontramos un 38,28 por ciento (intervalo de confianza [IC] del 95 por ciento, 31,13-45,95) de hiperinsulinismo, un 47,02 por ciento (IC del 95 por ciento, 39,70-54,47) de resistencia a la insulina (HOMA) y 41,08 por ciento (IC del 95 por ciento, 33,98-48,55) del SM calculado según criterios del Grupo Europeo de Resistencia a la Insulina (EGIR). CONCLUSIONES: En la población con cardiopatía isquémica existe una elevada prevalencia de factores de riesgo cardiovascular. Los pacientes con cardiopatía isquémica presentan mayor frecuencia de hiperinsulinismo, resistencia a la insulina y de síndrome metabólico. A pesar del tratamiento, existe una clara asociación entre el síndrome metabólico y la cardiopatía isquémica tanto en varones como en mujeres (AU)