Efficacy of statins in patients with STEMI depending on the T–786→C polymorphism of the endothelial NO-synthase gene promoter

April 7, 2020

The aim was to evaluate the efficacy of statins in STEMI patients depending on the T–786→C polymorphism of the eNOS gene promoter. Methods. It is a retrospective analysis of the database for 2003–2010. Patients with STEMI hospitalized within the first 24 hours of symptoms onset and assessed for –786TC eNOS gene polymorphism, were included. 65 patients were treated with statins (atorvastatin 20 mg or simvastatin 40 mg) starting from admission (group 1) and 92 patients did not received statins until discharge (group 2). Endothelium-dependent flow mediated dilatation was measured at admission and at day 7. Results. Statins decreased cholesterol concentration independent of eNOS genotype. In group 1, within 10 days of treatment, the level of total cholesterol decreased by 17.6% versus 4.3% in group 2 (p<0.01), and LDL cholesterol level decreased by 27.1% versus 6.1%, respectively (p<0.01). Significant improvement of flow mediated dilatation was observed in patients with –786TT-genotype treated by statins. –786TT-genotype was also associated with decreased risk of recurrent inhospital ischemic events (myocardial infarction and post-myocardial infarction angina) and acute heart failure in statin treated patients. There were no benefits of early statin treatment in patients with (TC + CC) genotypes. Conclusion. Moderate doses of statins initiated at day of admission effectively improve endothelial function and prevent in-hospital complications in STEMI patients with –786TT-genotype and does not affect these parameters in patients with –786TC- or –786CC-genotypes of eNOS gene.


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