The Relationship Of Genetic Polymorphisms Of Lymphotoxin-α And Tumor Necrosis Factor-α With Acute Coronary Syndrome

Object To study the relationship of lymphotoxin-αgene C804A polymorphism and human tumor necrosis factor-αwith acute coronary syndrome.Method 200 patients were selected for study from the inpatients of Tian Jin 1^st Central Hospital,Department of cardiology taken in from Oct 2007 and Nov 2008,all the selected patients received coronary angiography,the diagnosis of all the UAP or AMI were based on ACC/AHA Guidelines.The following clinic information was recorded:gender,age,smoking history, drinking history,CHD family history,diabetes family history,triglyceride,total cholesterol,low-density lipoprotein cholesterol,high density lipoprotein cholesterol, uric acid,fasting plasma glucose,etc.According to the results of coronary angiography,200 patients were divided into ACS group(120 patients) and control group(80 patients).ACS group was divided into UAP and AMI subgroup according to the type of ACS.Human plasma levels of tumor necrosis factor-αwere measured by enzyme-linked immunosorbent assay(ELISA).The genotypes of LTA gene C804A was analysed by polymerase chain reaction and agarose gel electrophoresis.Statistic method:Chi square test was used for comparing of numeration data between groups,measurement data was expressed with means±SD and T test was applied.P＜0.05 was considered to be statistic significance.Results Plasma concentrations of TNF-αin the controls were 61.74±7.71pg/ml (means±standard deviation),and in ACS group were 67.15±8.32 pg/ml.The TNF-αin ACS group were more higher than the controls(t=4.63 P＜0.01).There were 12 patients of single vessel lesion,38 patients of 2 vessels lesion, 70 patients of 3 vessels lesion.Their mean levels of TNF-αwere 61.89±6.65 pg/ml of single vessel lesion,71.80±2.32 pg/ml of 2 vessels lesion,72.12±6.37 pg/ml of 3 vessels lesion.TNF-αwere associated with the numbers of lesion coronary vessels in ACS group(P＜0.01).The levels of TNF-αin 2 vessels lesion group were significantly higher than in single vessel lesion(P＜0.01),the levels in 3 vessels lesion were higher than in single vessel lesion(P＜0.01).TNF-αwere no different between in 2 vessels lesion and in 3 vessels lesion(P＞0.05).120 patients were shared with 69 patients of unstable angina group,51 patients of acute myocardial infarction group.TNF-αlevels were 64.99±3.71 pg/ml in unstable angina group.TNF-αlevels were 72.26±4.78 pg/ml in acute myocardial infarction group.TNF-αlevels of acute myocardial infarction group were evidently higher than unstable angina group(P＜0.01).There were three kinds of genotypes,CC,AA,and CA of LTA gene 804.The genotype frequencies are shown in Table 2 and 3.The distributions of genotypes were equilibrium both in ACS group(P＞0.05) as well as in controls(P＞0.05). The levels of TNF-αamong the different genotypes did not change substantially both in controls(P＞0.05) and in single vessel lesion of cases(P＞0.05). The plasma levels of TNF-αamong the different genotypes were significantly different both 2 vessels lesion(P＜0.01) and 3 vessels lesion(P＜0.01) in cases.The levels of TNF-αin mutation genotypes(CA and AA) were higher than in CC type.Conclusion1,The levels of TNF-αwere associated with acute coronary syndrome.It can affect the occurrence,development and prognosis of the diseases.2,The association between LTA gene C804A polymorphism and acute coronary syndrome was not found.3,LTA gene C804A polymorphism was associated with the levels of TNF-αin ACS group.The levels of TNF-αwas higher along with the increasement of the numbers of lesion vessels of ACS patients with mutation genotype.