To elucidate the association of plasma factor VII coagulant activity (FVIIc) with the risk of myocardial infarction (MI) and to assess the influence of factor VII gene MspI polymorphism and lipid metabolism on FVIIc in the Chinese.
A total of 137 patients with angiographically confirmed MI and 125 healthy individuals were evaluated retrospectively. Plasma FVIIc was measured by one-stage prothrombin time, and FVII genotype was determined after MspI digestion of polymerase chain reaction-amplified genomic DNA. Serum lipid levels were assessed by routine methods.
MI patients had significantly higher levels of FVIIc (119.5% +/- 22.7% vs 99.9% +/- 21.8%, P < 0.01) and total serum cholesterol (5.80 +/- 1.06 mmol/L vs 5.53 +/- 1.08 mmol/L, P < 0.05) than controls, but only FVIIc independently correlated with the risk of MI (OR = 1.04, P < 0.01). There were no significant differences in FVII genotype or allele frequency between patients and controls (P > 0.05). Subjects with the Gln353 allele were associated with significantly lower FVIIc levels than Arg353 homozygotes (99.7% +/- 19.3% vs 111.4% +/- 24.6%, P < 0.05). Serum triglyceride was positively correlated with plasma FVIIc in both control (r = 0.25, P < 0.01) and case (r = 0.87, P < 0.01) groups, but this correlation was restricted to Arg/Arg genotype (r = 0.68, P < 0.01). A significant correlation of total serum cholesterol with FVIIc only appeared in Arg/Arg homozygotes (r = 0.17, P < 0.01).
Our findings support the role of plasma FVIIc as a risk factor for MI in Chinese. Plasma triglyceride and FVII gene MspI polymorphism are two independent determinants of FVIIc. Assay of this polymorphism will be helpful in determining who will benefit most from lipid-lowing therapy.