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Plasminogen activator inhibitor-1 5G/5G genotype is associated with early spontaneous recanalization of the infarct-related artery in patients presenting with acute ST-elevation myocardial infarction

Cagliyan, Caglar E.a; Yuregir, Ozge O.b; Balli, Mehmeta; Tekin, Kamurana; Akilli, Rabia E.a; Bozdogan, Sevcan T.b; Turkmen, Serdard; Deniz, Alic; Baykan, Oytun A.a; Aslan, Huseyinb; Cayli, Murata

doi: 10.1097/MCA.0b013e32835d7633
Pathophysiology and Natural History

Background We aimed to examine the association between plasminogen activator inhibitor-1 (PAI-1) genetic polymorphism and early spontaneous recanalization in patients presenting with acute ST-elevation myocardial infarction.

Methods Patients admitted to our emergency department with ST-elevation myocardial infarction in the first 6 h of symptom onset were included. An immediate primary percutaneous coronary intervention was performed. Patients were grouped according to the initial patency of the infarct-related artery (IRA) as follows: total occlusion (TO) group [Thrombolysis in Myocardial Infarction (TIMI) 0–1 flow in the IRA], partial recanalization group (TIMI 2 flow in the IRA), and complete recanalization (CR) group (TIMI 3 flow in the IRA). PAI-1 4G/5G polymorphism was detected using the real-time PCR method.

Results There were 107 patients in the TO group, 30 patients in the partial recanalization group, and 45 patients in the CR group. When we evaluated degrees of patency according to the PAI-1 genotype, TO of the IRA was the highest in patients with the PAI 4G/4G genotype (PAI-1 4G/4G: 66.7%, PAI-1 4G/5G: 65.9%, PAI-1 5G/5G: 40.4%) and CR of the IRA was the highest in patients with the PAI 5G/5G genotype (PAI-1 5G/5G: 38.5%, PAI-1 4G/5G: 19.8%, PAI-1 4G/4G: 17.9%). The distribution of genotypes in different degrees of patency of IRA was statistically significant (P=0.029). In logistic regression analysis, the PAI-1 5G/5G genotype was associated independently with the spontaneous CR of the IRA (odds ratio: 2.875, 95% confidence interval [1.059–7.086], P=0.038).

Conclusion Patients with the PAI-1 5G/5G genotype seem to be luckier than others in terms of early spontaneous recanalization of the IRA. Further prospective studies with large patient populations are required for more precise results.

Departments of aCardiology

bGenetics, Adana Numune Training and Research Hospital

cDepartment of Cardiology, Cukurova University, Adana

dDepartment of Cardiology, Gaziantep Konukoglu University, Gaziantep, Turkey

Correspondence to Caglar Emre Cagliyan, MD, Department of Cardiology, Adana Numune Training and Research Hospital, Adana 01330, Turkey Tel/fax: +90 322 338 69 33/+90 322 235 13 57; e-mail:

Received October 16, 2012

Accepted December 2, 2012

© 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins