FACTORS ASSOCIATED WITH THE PREVALENCE OF ATHEROSCLEROSIS IN PATIENTS WITH ISCHEMIC HEART DISEASE

The purpose of research was to study the possible link among traditional risk factors (RF) and polymorphism of endothelial NO-synthase (eNOS), angiotensin-converting enzyme (ACE) and angiotensin II receptor type 1 (AT2R1) with the prevalence of atherosclerosis in patients with ischemic heart disease (IHD). We examined 120 patients with IHD (108 men, 12 women) with stable angina of II-III functional class and the presence of hemodynamically significant coronary arteries (CA) stenoses, according to selective coronary angiography. Examinations of the patient group, except conventional ones, included determination of ankle-brachial index and Doppler ultrasound of the lower extremities and carotid artery with a quantitative intima-media thickness assessment. According to test results, patients were divided into two groups: I group consisted of 55 patients with evidence of atherosclerotic vascular disease in two and three basins, II group ? 65 patients with only CA atherosclerotic lesions. T-786S eNOS gene promoter allelic polymorphism, insertion-deletion (I / D) polymorphism of the ACE gene and polymorphism A1166S of AT2R1 gene were examined with the help of polymerase chain reaction. We performed statistical analysis using statistical software package ?Statistica 8.0? (StatSoft Inc, USA), Microsoft Office Exel-2003. For comparison of quantitative traits Student's t test was used, for qualitative traits ? Pearson's χ2 test. We conduct stepwise multivariate regression analysis to identify causal relationships between the studied parameters. We found, that other vascular basins, along with CA, are involved into atherosclerotic process for 48.5 % of patients with IHD. It was established, that patients with IHD and multilokus atherosclerotic lesions significantly frequently are carriers of eNOS gene T-786S polymorphism and AT2R1gene A1166S polymorphism mutant alleles than patients with CA lesions only. We proved the independent correlation between the development of advanced atherosclerosis in patients with IHD and such indicators as smoking, type II diabetes, family history of cardiovascular disease early onset, multivessel CA lesions and the presence of eNOS gene T-786S polymorphism C allele.