ИССЛЕДОВАНИЕ ПОЛИМОРФИЗМА rs1800629 (G-308А) ГЕНА TNF У БОЛЬНЫХ ИНФАРКТОМ МИОКАРДА С ПОДЪЁМОМ СЕГМЕНТА ST

Aim. To study the clinical and predictive importance of polymorphism of rs1800629 (G-308A) of TNF gene in patients with STEMI. Material and methods. Research included patients (171 persons with STEMI), hospitalized to the Kemerovo cardiological center and 188 individuals without the diagnosed cardiovascular diseases. In all patients the genotype had the polymorphism of rs1800629 of TNF gene. Investigation was carried out with help the original DNA microarray. Results. Associations of the rs1800629 (G-308A) polymorphic variant in the TNF gene with the concentration of the tumor necrosis factor alpha (TNFa) in the blood serum and cardiovascular complications in patients with myocardial infarction with the elevated ST segment (MIST) have been studied. Allele A rs1800629 frequency in patients with MIST (n=171) was 11,7% which did not differ from the frequency in healthy controls (n=188) – 12,2%. Allele A careerstatus was associated with the higher levels of the TNFa concentration in the blood serum measured at the day 10th-14th after MI: 11,02 pg/ml compared to 9,49 in G homozygotes (p=0,045). While analyzing the clinical status of MIpatients after one year follow up, it was revealed that A allele has the frequency 19% in patients with progressive angina pectoris (AP) compared to 10% in  patients without progressive AP, and 16% in patients with cardiovascula rcomplications (CVC) such as repeated MI, stroke, instable AP or death from cardiovascular reasons compared to 9% frequency in patients without CVC, which was not statistically significant. We had shown in earlier s tudy that TNFa high level in patients with MI is related to the risk of CVC. Although, in current study we did not detect an association of the rs1800629 with progression of the AP, chronic heart failure decompensation, CVC or death from cardiovascularreasons in one year after IM. Thus, rs1800629 allele A does influence TNFa concentrations, but there is no data supporting the fact that this variant is an independent risk factor for IM and its complications. Conclusion. The results indicate possible predictive value of rs1800629 polymorphism of TNF gene to predict the cardiovascular events in patients with STEMI during 12 months of follow up.