Lipoprotein(a) and the significance of the association between platelet glycoprotein IIIa polymorphisms and the risk of premature myocardial infarction


      Platelet glycoprotein IIb/IIIa may be involved in the pathogenesis of myocardial infarction as the key element in platelet aggregation and as the binding site of lipoprotein(a) to platelets, inhibiting plasminogen binding and activation. Recently, a strong association between the PlA2 polymorphism of the glycoprotein IIIa gene and acute coronary thrombosis has been reported, although this has not been confirmed. In an associated study, we determined plasma lipoprotein levels, the apo E genotype and the PlA genotype in 250 males under 55 years with myocardial infarction and they were compared with 250 age- and sex-matched controls. Patients showed an over-representation of the ϵ3/4 genotype with respect to the control group. We found that there were no differences in the allelic frequency of PlA2 between case patients and age-matched controls (χ2=0.05, P=0.92) and that subjects bearing the PlA2 allele showed higher plasma lipoprotein(a) concentration than PlA1/PlA1 individuals. Therefore, in this population there is no association between carriage of PlA2 allele and increased risk of myocardial infarction but the carriage of PlA2 is associated with higher plasma Lp(a) concentration.


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