Analysis Of MTHFR C677T Gene Polymorphism In Patients With Coronary Heart Disease Complicated With Hypertension

ObjectiveTo investigate the relationship between MTHFR gene polymorphism(C677T)and homocysteine level in patients with coronary heart disease(CHD)complicated with hypertension and to provide a new evidence for early assessment of the degree and risks of disease,Thus can guide clinical work.Methods1.160 patients who diagnosised with coronary heart disease complicated with hypertension positive result of coronary angiography were considered as a group,and there were 77 cases of simple hypertensive hospitalized patients with coronary angiography and 34 cases of healthy control group.The general clinical data and bloood biochemical parameter were collected.2.According to the results of coronary angiography(left anterior descending coronary artery,circumflex artery and right coronary artery at least one vascular stenosis ? 50% or left main coronary stenosis ? 30% is assessed as coronary heart disease)calculated the number of coronary lesions and gensini score to assess the extent of coronary artery disease.3.The level of homocysteine(Hcy)was measured by high performance liquid chromatography.The MTHFR C677 T genotype was determined by real-time quantitative PCR.According to the real-time quantitative PCR,the patients were divided into three groups,wild type CC and mutant CT or TT.MTHFR C677 T gene polymorphism of the patients were compared in the three groups.4.We counted the incidence of major cardiovascular adverse events in the patientsout of hospital within 1 year by regular telephone and outpatient follow-up.Results1.The level of Hcy(17.60 ±9.70 umol/L)in coronary heart disease complicated with hypertension group was higher than that in hypertensive group(16.56±7.70umol/L),but there was no significant difference(P>0.05).Rusults above were much higher than healthy controls(13.13±5.21 umol/L),which was significant difference(P<0.05).2.The frequency of T/T genotype in coronary heart disease complicated with hypertension group(35.5%)was significantly higher than that in healthy control group(14.7%)was significantly different,significance(P<0.05).3.The Gensini score and the Hcy level of patients with carrying T-mutated genes(C/T+T/T)(37.17±35.23,18.42±10.38 umol/L)was significantly higher than those with C/C genotype(27.28±21.63,14.81±6.23 umol/L),and the difference was statistically significant(P <0.05).4.The level of Hcy form male(19.40±10.32 umol/L)was significantly higher than that of female(14.06±6.32umol/L),which was significant difference(P<0.05).5.Multivariate logistic regression analysis showed that the difference of level of Hcy,age and serum creatinine which are a linear correlation have statistically significance(P<0.05).6.During the 1-year follow-up period,there were significant differences in the incidence of major cardiovascular adverse events among the three MTHFR C677 T genotype subgroups.The major cardiovascular events in the TT group were significantly higher than those in the CC and CT groups,and the difference was statistically significant(P<0.05).Conclusion1.The T gene mutation at the C677 T locus in the MTHFR gene polymorphism in patients with coronary heart disease complicated with hypertension was correlated with the severity of coronary artery disease.2.The patients with high Hcy levels and T mutations are associated with the incidence of coronary heart disease.The incidence of the coronary heart disease in the population with high Hcy levels and T mutations may be high.3.The patients with MTHFR C677 T locus TT genotype have a higher incidence of major cardiovascular adverse events.4.High creatinine may be a risk factor for coronary heart disease.