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European Heart Journal Advance Access originally published online on November 29, 2006
European Heart Journal 2007 28(1):13-18; doi:10.1093/eurheartj/ehl410
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© The European Society of Cardiology 2006. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Increased risk of acute myocardial infarction and elevated levels of C-reactive protein in carriersof the Thr-87 variant of the ATP receptor P2Y11

Stefan Amisten1, Olle Melander2, Anna-Karin Wihlborg1, Göran Berglund2 and David Erlinge1,*

1 Department of Cardiology, Lund University Hospital, SE-221 85 Lund, Sweden
2 Department of Clinical Sciences,Malmö, Lund University, Lund, Sweden

Received 10 June 2006; revised 24 September 2006; accepted 9 November 2006; online publish-ahead-of-print 29 November 2006.

* Corresponding author. Tel: +46 46172597; fax: +6 46157857. E-mail address: david.erlinge{at}med.lu.se

Aims Extracellular ATP acting on the P2Y11 receptor regulates inflammatory cells. We hypothesized that polymorphisms in the receptor could influence the risk of acute myocardial infarction (AMI).

Methods and results In the Malmö diet and cancer AMI case–control study (n = 3732) the P2Y11 gene Thr-87 polymorphism was present in 19.8% of the controls and 22.9% in AMI patients (OR 1.21; P = 0.03). Stronger associations were found in patients with family history (FH) of AMI, 1.32; early-onset (EO) AMI, 1.43; or EO AMI combined with FH, 1.50; supporting a genetic mechanism. The Thr-87 homozygotes had an even greater risk of AMI, 1.94 (P = 0.04); and 2.48 in the EO AMI subgroup, suggesting a genetic dosage effect. In the cardiovascular risk factor group (n = 6055), 21.3% carried the Thr-87 allele. C-reactive protein was elevated in Thr-87 carriers: 1.6 mg/L vs. 1.3 mg/L (P = 0.001). No difference was seen for blood pressure, lipids, body mass index, smoking, or diabetes mellitus.

Conclusion The common Ala-87-Thr polymorphism of the P2Y11 receptor is associated with AMI and increased levels of C-reactive protein. We hypothesize that an inflammatory mechanism might be involved. The P2Y11 receptor is a promising new drug target in the prevention of AMI.

Key Words: P2Y • Receptor • Myocardial infarction • Inflammation • Genetics • Human


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