Hereditäre Suszeptibilitätsfaktoren für die koronare Herzerkrankung als Basis einer individualisierten Arzneitherapie

by Meisel, Christian

Genetic susceptibility factors for cardiovascular diseases and disease complications are being investigated intensively within pharmacogenomics research programs. We studied polymorphisms in candidate genes of the coagulation system (platelet glycoproteins Ibalpha, Ia/IIa, coagulation factor VII) and of the homocysteine system (MTHFR, interaction with the endothelial NO-synthase) in their association to coronary artery disease and thrombotic complications. The results suggest that both the Kozak sequence polymorphism of the glycoprotein Ibalpha gene and the Arg353Gln polymorphism of the coagulation factor VII gene may be possible risk predictors for early complications following coronary catheter interventions. Moreover, in hyperhomocysteinemic patients, women were at higher risk for acute coronary syndromes with increasing numbers of CA repeats of the intron 13 CA repeat polymorphism of the endothelial NO-synthase gene. This effect modification was not observed in men. The other candidate genes did in our study population not prove to be suitable for risk prediction of coronary artery disease and of complications following coronary catheter interventions. The results also demonstrate methodological challenges in association studies on genetic influences on complex diseases such as coronary artery disease. Therefore, replication in independent populations is necessary. After confirmation, these hereditary susceptibility factors could be utilised for an improved risk assessment after catheter interventions. In terms of increasingly individualised treatment, these susceptibility factors could contribute to the identification of patients, who are in need of more intensive monitoring and treatment, e.g. in coronary artery disease and coronary catheter interventions.