| ObjectiveTo study the distribution characteristics of MTHFR C677 T gene polymorphism in patients with premature coronary heart disease,mature coronary heart disease and control group in the North of Anhui Province,and to investigate the relevance of the onset age,sex,homocysteine level,the degree and disease prognosis in patients with coronary heart disease and the polymorphisms of this gene.Methods1.542 patients in the north of Anhui Province were enrolled in the Department of Cardiology in our hospital and collected clinical data of patients' history,blood pressure,blood glucose,and blood lipids for statistical description.2.According to coronary angiography results,patients were divided into coronary heart disease group(n=463)and control group(n=79),patients with coronary heart disease were divided into premature coronary heart disease group(n=177)and mature coronary heart disease group(n=286)based on the onset age.3.Fluorescent quantitative PCR was used to determine the patient's MTHFR C677 T genotype and patients were classified as wild-type(CC,n=127)and mutation-type(CT,n=256 or TT,n=159)based on the test results.,the MTHFR C677 T gene polymorphism was compared among the three groups of patients.S-adenosyl homocysteine hydrolase reaction was used to detect serum homocysteine? ? levels.4.Conduct regular telephone or outpatient follow-ups to count the incidence of Major Adverse Cardiovascular Events within 6 months of discharged patients.Results1.There were significant differences in the incidence of MTHFR C677 T gene mutations among the three groups of patients.The tate of the gene mutations in the mature coronary heart disease group were significantly higher than those in the premature coronary heart disease group(80.1% vs 70.1%,P<0.01).The mutation of the mature coronary heart disease group was higher than those of the control group(80.1%vs 78.5%),but the difference was not statistically different.There was no significant difference in the mutation between the premature coronary heart disease group and the control group(70.1% vs 78.5%,P>0.05).2.The levels of homocysteine in patients with different MTHFR C677 T genotypes were significantly different(P<0.01).The levels of homocysteine in TT genotype group were significantly higher than those in CT and CC groups(P<0.01).3.The number of vascular lesions in the mature coronary artery disease group was more than that of the premature coronary heart disease group.There was no significant difference in the number of vascular lesions in patients with different MTHFR C677 T genotypes.4.The proportion of males of mature coronary heart disease group was significantly higher than that of the control group,the proportion of women and triglyceride levels of premature coronary heart disease group were significantly higher than those of mature coronary heart disease(P<0.01).5.Multivariate logistic regression analysis showed that high fasting plasma glucose and cystatin C are risk factors for coronary heart disease.Women are risk factors for premature coronary heart disease.Men are risk factors for mature coronary heart disease.MTHFR C677 T gene may increase the incidence of premature coronary heart disease(OR=1.63,CI: 0.77~3.37),but it was not statistically significant.6.After 6 months of follow-up,there were significant differences in the incidence of major cardiovascular adverse events among the three MTHFR C677 T genotypesubgroups.Cardiovascular events in the TT group were significantly higher than those in the CC and CT groups.Conclusion1.MTHFR C677 T polymorphism may be associated with the mature of coronary heart disease in the north of Anhui Province.Patients with T gene mutations may have a higher risk of mature coronary heart disease.2.Patients with MTHFR C677 T TT genotype have higher serum homocysteine levels.3.Patients with MTHFR C677 T TT genotype have higher incidence of major cardiovascular adverse events4.High triglycerides may be the risk factors of premature coronary heart disease. |
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