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Factor V Leiden Does Not Modify the Phenotype of Acute Coronary Syndrome or the Extent of Myocardial Necrosis.
- Source :
-
Journal of the American Heart Association [J Am Heart Assoc] 2021 Jun; Vol. 10 (11), pp. e020025. Date of Electronic Publication: 2021 May 17. - Publication Year :
- 2021
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Abstract
- Background The prothrombotic defect factor V Leiden (FVL) may confer higher risk of ST-segment-elevation myocardial infarction (STEMI), compared with non-ST-segment-elevation acute coronary syndrome, and may be associated with more myocardial necrosis caused by higher thrombotic burden. Methods and Results Patients without history of cardiovascular disease were selected from 2 clinical trials conducted in patients with acute coronary syndrome. FVL was defined as G-to-A substitution at nucleotide 1691 in the factor V (factor V R506Q) gene. Odds ratios were calculated for the association of FVL with STEMI adjusted for age and sex in the overall population and in the subgroups including sex, age (≥70 versus <70 years), and traditional cardiovascular risk factors. The peak biomarker levels (ie, creatine kinase-myocardial band and high-sensitivity troponin I or T) after STEMI were contrasted between FVL carriers and noncarriers. Because of differences in troponin assays, peak high-sensitivity troponin levels were converted to a ratio scale. The prevalence of FVL mutation was comparable in patients with STEMI (6.0%) and non-ST-segment-elevation acute coronary syndrome (5.8%). The corresponding sex- and age-adjusted odds ratio was 1.06 (95% CI, 0.86-1.30; P =0.59) for the association of FVL with STEMI. Subgroup analysis did not show any differences. In patients with STEMI, neither the median peak creatine kinase-myocardial band nor the peak high-sensitivity troponin ratio showed any differences between wild-type and FVL carriers ( P for difference: creatine kinase-myocardial band=0.33; high sensitivity troponin ratio=0.54). Conclusions In a general population with acute coronary syndrome, FVL did not discriminate between a STEMI or non-ST-segment-elevation acute coronary syndrome presentation and was unrelated to peak cardiac necrosis markers in patients with STEMI. Registration URL: https://www.clinicaltrials.gov; Unique identifiers: NCT00391872 and NCT01761786.
- Subjects :
- Acute Coronary Syndrome complications
Acute Coronary Syndrome diagnosis
Biomarkers blood
DNA genetics
DNA Mutational Analysis
Electrocardiography
Factor V genetics
Female
Follow-Up Studies
Humans
Male
Middle Aged
Mutation
Necrosis blood
Necrosis diagnosis
Necrosis etiology
Phenotype
Retrospective Studies
Risk Factors
Acute Coronary Syndrome blood
Factor V metabolism
Myocardium pathology
Subjects
Details
- Language :
- English
- ISSN :
- 2047-9980
- Volume :
- 10
- Issue :
- 11
- Database :
- MEDLINE
- Journal :
- Journal of the American Heart Association
- Publication Type :
- Academic Journal
- Accession number :
- 33998271
- Full Text :
- https://doi.org/10.1161/JAHA.120.020025