Factor V Leiden and Plasminogen-Activator-Inhibitor-1 polymorphisms are genetic determinants of coronary artery disease in CABG patients

Objective: Gene polymorphisms of thrombolytic, lipoprotein and immological pathways are supposed to play a role in the pathogenesis of CAD (coronary artery disease). CAD accumulates in families, but does not segregate like a Mendelial single-gene disorder, indicating that atherosclerosis is basically a multifactorial disease. Method: We determined and compared 10 genetic mutations in homocygote or heterocygote occurrence in two cohorts: 314 patients with CAD following CABG operation and 500 healthy Caucasian. Factor V Leiden and Prothrombin are sensitive markers for venous thrombosis; Plasminogen-Activator-Inhibitor-1, Angiotensin Converting Enzyme, Methylentetrahydrofolatreductase, Cholesterinester-Transferprotein and Apolipoprotein E express risk for atherosclerosis; Glycoproteins (three polymorphisms) represent the risk for platelet induced thrombosis. Results: The analysis shows significant differences in two pathways. We found increased occurrence of FV Leiden (p=0.0034, OR 2.33) and PAI-1 (p=0.004, OR=1.34) in CABG patients compared to the control. There was also a higher mutation rate of GP Ia 807 in the CABG group. Discussion: With the identification of two polymorphisms involved in the metabolic path-ways of thrombus aggregation in CABG patients, there might be a future possibility in the screening, prediction and prevention of CAD in the population.