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Revista Española de Cardiología (English Edition) Revista Española de Cardiología (English Edition)
Rev Esp Cardiol. 2017;70:34-41 - Vol. 70 Num.01 DOI: 10.1016/j.rec.2016.05.024

Coronary Artery Atherosclerosis in Hypertensive Patients: The Role of Fibrinogen Genetic Variability

Nikolaos Papageorgiou a,b, Alexandros Briasoulis a,c, Georgios Hatzis a, Emmanuel Androulakis a,d, Maria Kozanitou a, Antigoni Miliou a, Marietta Charakida e, Effimia Zacharia a, Spyridon Papaioannou a, Ioannis Paroutoglou a, Gerasimos Siasos a, Zoi Pallantza a, Dimitris Tousoulis a,

a 1st Cardiology Department, Athens University Medical School, Hippokration Hospital, Athens, Greece
b Barts Heart Centre, St. Bartholomew's Hospital, London, United Kingdom
c Cardiovascular Institute, Wayne State University, Detroit, United States
d Department of Cardiology, John Radcliffe, Oxford University Hospital, Oxford, United Kingdom
e Department of Cardiovascular Imaging, King's College, London, United Kingdom

Keywords

Coronary artery disease. Fibrinogen. Hypertension. Polymorphisms.

Abstract

Introduction and objectives

We examined whether the rs180070 and rs2070011 polymorphisms of the fibrinogen gene could affect the risk of coronary artery disease in hypertensive patients by modifying the inflammatory process and coagulation.

Methods

A total of 744 participants underwent coronary angiography due to symptoms of stable angina, while hypertension was present in 332 patients.

Results

The presence of the A allele (rs180070) was associated with significantly high levels of fibrinogen in hypertensive patients (P = .05). On multivariate analysis, A homozygosity (rs180070) (β = 0.257 ± 18.6; P < .001), but not hypertension status (β = 0.05 ± 11.9; P = .29) was an independent predictor of fibrinogen levels. In hypertensive patients, higher fibrinogen levels > 443 mg/dL (odds ratio = 3.50; 95% confidence interval, 1.14-10.90; P = .029), but not A homozygosity (odds ratio = 3.00; 95% confidence interval, 0.78-11.90; P = .110) were independent predictors of the presence of coronary artery disease. Moreover, interleukin-6 levels were higher in A homozygotes for the rs180070 polymorphism compared with all other genotypes (P = .046). Indeed, this genotype was the only adjusted independent predictor of interleukin-6 levels (β = 0.151 ± 0.642; P = .032). It was also associated with higher D-dimer levels in hypertension compared with G allele carriers (P = .048).

Conclusions

The presence of A homozygosity (rs180070) is associated with increased levels of inflammatory mediators and a higher incidence of angiographic coronary artery disease. Importantly, fibrinogen is an independent predictor of the angiographic presence of coronary artery disease in hypertensive patients.

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