PIA polymorphism of glycoprotein IIIa and efficacy of reperfusion therapy in patients with acute myocardial infarction

Olga Gorchakova, Werner Koch, Julinda Mehilli, Nicolas Von Beckerath, Markus Schwaiger, Albert Schömig, Adnan Kastrati

Research output: Contribution to journalArticlepeer-review

14 Scopus citations

Abstract

The PIA polymorphism of the platelet glycoprotein IIIa gene is associated with altered platelet function and response to antiplatelet drugs. We sought to assess whether the PIA polymorphism influences myocardial salvage achieved by reperfusion therapy in patients with acute myocardial infarction. We analyzed 292 patients enrolled in 2 randomized trials that compared stenting plus abciximab with thrombolysis (alteplase alone or alteplase plus abciximab) in acute myocardial infarction. Patients were genotyped for the PIA polymorphism using polymerase chain reaction with fluorogenic probes. Technetium-99m sestamibi was injected before and 1-2 weeks after reperfusion treatment. The scintigrams enabled the calculation of the initial perfusion defect, final infarct size, and the proportion of initial defect salvaged by reperfusion (salvage index). Clinical follow-up was done up to 18 months after primary treatment. The genotype distribution was as follows: PIA2/A2 in 3.4%, PIA1/A2 in 24.7% and PIA1/A1 in 71.9% of patients. There were no significant differences between PIA2 allele carriers and PIA1/A1 patients in salvage index (0.46±0.50 vs. 0.41±0.43, respectively, P=0.48), final infarct size (16.8±20.8% vs. 18.4±19.1% of left ventricle, respectively, P=0.46) as well as 18-month mortality (8.5% vs. 7.1%, respectively, P=0.69). The lack of relationship between PIA2 allele and myocardial salvage was observed for both reperfusion strategies, stenting and thrombolysis. Thus, these findings show that the functional PIA polymorphism of platelet glycoprotein IIIa has no influence on the degree of myocardial salvage achieved by reperfusion therapies in patients with acute myocartiial infarction.

Original languageEnglish
Pages (from-to)141-145
Number of pages5
JournalThrombosis and Haemostasis
Volume91
Issue number1
DOIs
StatePublished - Jan 2004

Keywords

  • Acute myocardial
  • Glycoprotein IIIa
  • Infarction
  • PI polymorphism
  • Platelets
  • Reperfusion

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