Clinical and genetic predictors of ischemic stroke

Objective. To investigate the associations of polymorphic variants rs3025058 of the ММР‑3 gene with ischemic stroke occurrence in patients with cardiovascular pathology in a case-control study. Design and methods. The main group included 255 patients admitted to the hospital due to ischemic stroke. The control group included ageand sex-matched 272 patients without ischemic stroke. The age in the main group varied from 32 to 69 years [57,0; 51,0–62,0], the age of patients without ischemic stroke (control group) varied from 37 to 68 years [55,0; 51,0–62,0]. The main group included 157 men [56,5; 51,0–62,0 years] and 103 women [57,0; 51,0–62,0 years]. The control group included 170 men [55,0; 51,0–62,0 years] and 102 women [55,0; 51,0–62,0 years]. Hospitalized patients with ischemic stroke underwent clinical examination, computed tomography scans of the brain, electrocardiography, echocardiography, ultrasound duplex scanning of extracranial brachiocephalic arteries, daily monitoring of blood pressure and heart rate, analysis of the blood coagulation parameters. A molecular genetic analysis was performed (polymorphic variants rs3025058 of the ММР‑3 gene). The recruitment lasted for three years. Results. We found statistically significant associations between the 5a/5a genotype, the 5a allele of the ММР‑3 gene and ischemic stroke. In the subgroup of patients with cardiac arrhythmias, the associations were significant only for the 5a allele, while there were no significant associations between ischemic stroke occurrence and rs3025058 (5a/6a) of the ММР‑3 gene in the subgroup of women with ischemic stroke, subgroups of patients with arterial hypertension and hypercoagulation. Genotype 5a/5a and allele 5a were associated with the ischemic stroke in the whole group, as well as in males, and in subgroups with atherosclerosis of brachiocephalic arteries and dyslipidemia. In the subgroup of patients with cardiac arrhythmias, only 5a allele of the ММР‑3 gene was associated with ischemic stroke, while no associations were found between the rs3025058 (5a/6a) allele of the ММР‑3 gene and ischemic stroke in females, and in subgroups with arterial hypertension and hypercoagulation. Conclusion. The homozygous genotype 5a/5a and the 5a allele of the ММР‑3 gene might be genetic predictors of ischemic stroke. The study of the genetic risk factors for ischemic stroke is important for the personalized approach to the management of both outpatients and inpatients with cardiovascular diseases.

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