The Rs12526453 Polymorphism In An Intron Of The Phactr1 Gene And Its Association With 5-Year Mortality Of Patients With Myocardial Infarction

ObjectiveThe rs12526453 (C/G) is a single nucleotide polymorphism in an intron of the PHACTR1 gene (phosphatase and actin regulator 1). The C allele is associated with increased risk of coronary artery disease in an unknown mechanism. We investigated its association with long-term overall mortality in patients with ST-elevation myocardial infarction (STEMI) treated invasively.MethodsTwo independent groups of patients with STEMI were analyzed: a derivation group (n=638) and a validation one (n=348). Genotyping was performed with the TaqMan method. The analyzed end-point was total long term mortality. Additionally, transcriptomic analysis was performed in mononuclear blood leukocytes from rs12526453 CC monozygotes or G allele carriers.ResultsIn the study group (mean age 62.3 +/- 11.9 years; 24.9% of females, n=159), percentages of CC, CG, and GG genotypes were 45.3%(n=289), 44.7%(n=285), and 10% (n=64), respectively. In the 5-year follow-up 105 patients died (16.46%). CC homozygotes had significantly lower mortality compared to other genotypes: 13.1% (n=38) vs. 18.3% in G-allele carriers (n=67), (p=0.017, Cox's F test). In the validation group 47 patients died within 3 years (13.5%). We confirmed lower mortality of CC homozygotes: 10.1 %(n=18) vs. 16.95% in G-allele carriers (n=29), (p=0.031, Cox's F test). Transcriptomic analysis revealed a markedly higher expression of NLRP-2 in CC homozygotes.ConclusionsThe rs12526453 CC homozygotes (previously associated with increased risk of myocardial infarction) showed, in 2 independent samples, better long-term survival. The finding of such high effect size, after appropriate validation, could potentially be translated into clinical practice.