Molecular and genetic markers for coronary heart disease prognosis in elderly patients

The molecular and genetic markers for primary and secondary prevention of coronary heart disease (CHD) were identified based on the analysis of lipid metabolism gene polymorphisms - lipoprotein lipase (LPL); apolipoprotein E (apoE); and I/D polymorphism of ACE in CHD patients from various age groups, including elderly individuals, and with various clinical variants of CHD (II-III Functional Class stable angina, unstable angina, myocardial infarction (MI), post-infarction cardiosclerosis), as well as in the control group of healthy volunteers. ACE gene DD genotypes, LPL gene H+/+ genotypes, and E3E4 increased the MI risk in CHD patients and could be regarded as high-risk markers [4,6-8]. Genotype DD was associated with higher risk of recurrent MI, life-threatening MI complications, and severe heart failure. Moreover, DD genotype was linked to specific personality traits (hostility and Type A behavior), which act as psychological risk factors of CHD and explain delayed medical attendance [2,9]. ApoE gene epsilon 2 allele and LPL gene H allele were observed significantly more often in CHD patients aged over 90 years, compared to younger individuals. Therefore, these alleles could be regarded as the markers of stable clinical CHD course [4].