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Previous Volume 334:1090-1094 April 25, 1996 Number 17 Next

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ABSTRACT

Background Platelet glycoprotein IIb/IIIa is a membrane receptor for fibrinogen and von Willebrand factor, and it has an important role in platelet aggregation. It is known to be involved in the pathogenesis of acute coronary syndromes. Previously, we found a high frequency of a particular polymorphism, Pl^A2, of the gene encoding glycoprotein IIIa in kindreds with a high prevalence of premature myocardial infarction.

Methods To investigate the relation between the Pl^A2 polymorphism and acute coronary syndromes, we conducted a case–control study of 71 case patients with myocardial infarction or unstable angina and 68 inpatient controls without known heart disease. The groups were matched for age, race, and sex. We used two methods to determine the Pl^A genotype: reverse dot blot hybridization and allele-specific restriction digestion.

Results The prevalence of Pl^A2 was 2.1 times higher among the case patients than among the controls (39.4 percent vs. 19.1 percent, P = 0.01). In a subgroup of patients whose disease began before the age of 60 years, the prevalence of Pl^A2 was 50 percent, a value that was 3.6 times that among control subjects under 60 years of age (13.9 percent, P = 0.002). Among subjects with the Pl^A2 polymorphism, the odds ratio for having a coronary event was 2.8 (95 percent confidence interval, 1.2 to 6.4). In the patients less than 60 years of age at the onset of disease, the odds ratio was 6.2 (95 percent confidence interval, 1.8 to 22.4).

Conclusions We observed a strong association between the Pl^A2 polymorphism of the glycoprotein IIIa gene and acute coronary thrombosis, and this association was strongest in patients who had had coronary events before the age of 60 years.

Source Information

From the Department of Medicine, Divisions of Cardiology (E.J.W., S.P.S., L.C.B., J.L.W., G.G., P.J.G.-C.) and Hematology (E.J.W., P.F.B., T.S.K.), the Department of Pathology (P.F.B., T.S.K.), and the Department of Cell Biology and Anatomy (P.J.G.-C.), Johns Hopkins University School of Medicine; and Johns Hopkins University School of Hygiene and Public Health (M.T.) — both in Baltimore.

Address reprint requests to Dr. Goldschmidt-Clermont at Bernard Laboratory, Ross 1023, Johns Hopkins Medical School, 720 Rutland Ave., Baltimore, MD 21205.

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Platelet Glycoprotein IIIa Pl ^A Polymorphism and Myocardial Infarction
Marian A.J., Brugada R., Kleiman N. S., Carter A. M., Ossei-Gerning N., Grant P. J., Goldschmidt-Clermont P. J., Bray P. F.
Extract | Full Text  
N Engl J Med 1996; 335:1071-1074, Oct 3, 1996. Correspondence

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