Association of tissue plasminogen activator and plasminogen activator inhibitor polymorphism with myocardial infarction: a meta-analysis.

INTRODUCTION: To investigate whether t-PA Alu repeat insertion/deletion (I/D) and PAI-1 4G/5G genetic variations are associated with the risk of MI. METHODS: We conducted a meta-analysis to assess the association between the t-PA I/D and PAI-1 4G/5G polymorphisms and risk of MI. We also performed subgroup analyses based on ethnicity (Caucasian, Asian, and African), gender and age. Forty one eligible studies including 12,461 cases and 14,993 controls were identified to evaluate the impact of PAI-1 4G/5G polymorphism on MI. Seven studies investigated the relationship between t-PA I/D and MI. RESULTS: This meta-analysis revealed that the PAI-1 4G allele (4G/4G and 4G/5G genotype) was associated with an increased risk of MI compared with the 5G allele in the overall population (OR=1.094, 95% CI=1.021 - 1.172, p=0.011). The relative risks of MI for 4G/4G genotype was increased when compared to 5G/5G genotype and 5G allele, with odds ratio at 1.157 (95% CI 1.015 - 1.320, p=0.029) and 1.126 (95% CI =1.015 - 1.249, p=0.025). However, the results show that the 4G/5G polymorphism risk for MI was not associated with ethnicity stratification as Caucasian, Asian or African population. No substantial differences in the genotype distributions were observed in the MI group and control group along the lines of gender and age. After multivariable analysis t-PA I/D polymorphism showed no consistent association with MI. CONCLUSIONS: This study suggests that the 4G/5G polymorphism of PAI-1 may be a risk factor for MI in overall populations.