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Prospective analysis after coronary-artery bypass grafting: platelet GP IIIa polymorphism (HPA-1b/PIA2) is a risk factor for bypass occlusion, myocardial infarction, and death.

Abstract
Recently, we have demonstrated that human platelet antigen 1b (HPA-1b or P1A2) is a hereditary risk factor for platelet thrombogenicity leading to premature myocardial infarction in preexisting coronary artery disease. However, HPA-lb does not represent a risk factor for coronary artery disease itself. The aim of our present study was to evaluate the role of HPA-lb on the outcome in patients after coronary-artery bypass surgery. We prospectively determined the HPA-1 genotype in 261 consecutive patients prior to saphenous-vein coronary-artery bypass grafting. The patients were followed for one year. Among patients with bypass occlusion, myocardial infarction, or death more than 30 days after surgery, the prevalence of HPA-lb was significantly higher than among patients without postoperative complications (60 percent, 6/10, vs. 24 percent, 58/241, p <0.05, odds ratio 4.7). Using a stepwise logistic regression analysis with the variables HPA-1b, age, sex, body mass index, smoking (pack-years), hypertension, diabetes, cholesterol and triglyceride concentration, only HPA-lb had a significant association with bypass occlusion, myocardial infarction, or death after bypass surgery (p = 0.019, odds ratio 4.7). This study shows that HPA-1b is a hereditary risk factor for bypass occlusion, myocardial infarction, or death in patients after coronary-artery bypass surgery.
AuthorsR B Zotz, M Klein, H P Dauben, C Moser, E Gams, R E Scharf
JournalThrombosis and haemostasis (Thromb Haemost) Vol. 83 Issue 3 Pg. 404-7 (Mar 2000) ISSN: 0340-6245 [Print] Germany
PMID10744144 (Publication Type: Journal Article)
Chemical References
  • Antigens, CD
  • DNA Primers
  • Integrin beta3
  • Platelet Membrane Glycoproteins
Topics
  • Aged
  • Antigens, CD (genetics)
  • Base Sequence
  • Coronary Artery Bypass (adverse effects, mortality)
  • Coronary Disease (blood, genetics, surgery)
  • DNA Primers (genetics)
  • Female
  • Genotype
  • Humans
  • Integrin beta3
  • Male
  • Middle Aged
  • Myocardial Infarction (blood, etiology, genetics)
  • Platelet Membrane Glycoproteins (genetics)
  • Polymorphism, Genetic
  • Prospective Studies
  • Risk Factors

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