Lack of association of the plasminogen activator inhibitor‐1 4G/5G promoter polymorphism with cardiovascular disease in the elderly

Elevated circulating plasminogen activator inhibitor‐1 (PAI‐1) may increase risk of cardiovascular disease (CVD). The 4G allele of the 4G/5G PAI‐1 promoter polymorphism is associated with higher levels of PAI‐1. We examined the association of PAI‐1 4G/5G genotype and CVD events in the elderly participants of the Cardiovascular Health Study (CHS). We measured 4G/5G genotype in a nested case‐control study within the CHS. Cases included incident angina, myocardial infarction (MI), and stroke. 4G/5G genotype was not found to be associated with markers of fibrinolysis or CVD risk in the selected elderly cohort. There were no differences in genotype frequencies by case‐control status (5G/5G frequency 16–22%; χ2P= 0.07). The 5G allele was not associated with incident CVD events when individuals with at least one 5G allele were compared to 4G/4G homozygotes. The presence of at least one 4G allele was likewise not associated with incident CVD when those with 4G/4G and 4G/5G genotypes were compared to 5G/5G homozygotes. Our results suggest that the PAI‐1 4G/5G promoter polymorphism is not associated CVD risk factors or incident CVD events in the elderly.