Korean J Med.  2000 Jan;58(1):19-27.

eNOS gene polymorphism in patients with acute coronary syndrome or variant angina in Korean

• Choi SY
• Yoo KH
• Park JS
• Chae IH
• Kim HS
• Son DW
• Oh BH
• Lee MM
• Park YB
• Choi YS
• Lee YW

Abstract

BACKGROUND: Nitric oxide, also known as endothelial derived relaxing factor(EDRF), regulates the vascular tone and inhibits the proliferation of vascular smooth muscle cells and platelet adhesions and endothelium-leukocyte interactions. Thus, nitric oxide may be involved in the pathogenesis of atherosclerosis and vasospasm. We analyzed the genotype distributions of two eNOS gene polymorphisms in normal healthy Koreans and compared it with those in the patients with acute coronary syndrome and variant angina.
METHODS
We analyzed the two eNOS polymorphisms (eNOS A/B polymorphism is the variable numbers of tandem repeat in intron 4 and eNOS T/G polymorphism is a mis-sense mutation in exon 7) using PCR and clinical characteristics of the risk factors for coronary artery disease in 142 normal healthy Koreans and 164 patients with acute coronary syndrome and 104 patients with variant angina.
RESULTS
The genotype distribution of A/B polymorphism of eNOS gene, A/A, A/B, B/B was 4.9%, 21.1%, 74% in control group and 2.4%, 12.8%, 84.8% in the patients with acute coronary syndrome(p=0.02) and 2.9%, 16.3%, 80.8% in the patients with variant angina(p=NS), respectively. The genotype distribution of T/G polymorphism of eNOS gene, T/T, T/G, G/G was 1.4%, 15.5%, 83.1% in control group and 0.6%, 21.3%, 78.1% in the patients with acute coronary syndrome(p=NS) and 0%, 18.3%,81.7% in the patients with variant angina(p=NS), respectively. The odds ratio for acute coronary syndrome of non B/B(A/A & A/B) to B/B was 0.489 (95% CI : 0.257-0.928). We found that age, sex (male), diabetes mellitus, hyperlipidemia, smoking, B/B genotype were independent risk factors for acute coronary syndrome. But, in variant angina, smoking was the only significant independent risk factor(odds ratio=5.934, 95% CI 2.843-12.388, p< 0.05).
CONCLUSION
The B/B genotype frequency of eNOS gene was significantly higher in patients with acute coronary syndrome than in normal controls. But neither A/B nor T/G polymorphism of eNOS gene was associated with variant angina. These results suggest that eNOS gene may play some roles in the pathogenesis of ACS rather than vasospasm.

Keyword

Endothelial nitric oxide synthase gene polymorphism; Acute coronary syndrome; Variant angina

MeSH Terms

Acute Coronary Syndrome*
Atherosclerosis
Blood Platelets
Coronary Artery Disease
Diabetes Mellitus
Exons
Genotype
Humans
Hyperlipidemias
Introns
Muscle, Smooth, Vascular
Nitric Oxide
Odds Ratio
Polymerase Chain Reaction
Risk Factors
Smoke
Smoking
Tandem Repeat Sequences
Nitric Oxide
Smoke