Clinical-genetic riskometer for the ischemic stroke risk assessment in atrial fibrillation

Abstract

Aim. To assess genetic issues in the ischemic stroke development in AF and to invent an analytical programmed complex for genetic risk estimation of stroke development in a patient with AF. Material and methods. Totally 43 patients studied with AF and stroke in anamnesis, 78 — with AF and no stroke. Controls consisted of 188 persons without cardiovascular pathology. The participants underwent ECG, EchoCG, Holter ECG-monitoring, exercise test, TELAS, thyroid gland hormones analysis. For confirmation of the ischemic nature of stroke in participating probands we performed computed tomography of the brain. All participants also underwent molecular genetic testing. Results. According to the odds ratio, allele A polymorphism -455G>A of gene FGB increases the risk of ischemic stroke development in atrial fibrillation 1,7 times comparing to those patients without the allele; genotypes with the rare T allele in homo- and heterozygous state of polymorphism 807C>T of gene GPIα increases 2,5 times the risk of stroke in AF; presence of allele C polymorphism -5T>C of gene GPIβα increases 1,9 times the risk of stroke comparing to its absence; presence of the rare genotypes allele C in homo- and heterozygous state -5T>C of gene GPIβα increases 2,3 times stroke risk; allele A of the polymorphism 10976G>A gene FVII decreases the risk of stroke 2,6 times. According to the results, there was a “Clinical-genetic riskometer of the ischemic stroke in AF” developed. Using this informational-analytic complex it is possible to estimate genetic risk of the stroke. Conclusion. Therefore, the study has shown that homozygous genotype AA of the rare polymorphism 455G>A gene FGB, heterozygous genotype CT and homozygous genotype TT of the rare polymorphism allele 807C>T gene GPIα, heterozygous genotype TC and homozygous genotype CC by the rare allele polymorphism -5T>C gene GPIβα are defined as genetic predictors of ischemic stroke development in atrial fibrillation. Allele A of polymorphism 10976G>A gene FVII is protective against ischemic stroke in patients with AF. Knowing the parameters of genetic assessment in AF, it is possible to calculate genetic risk of ischemic stroke development in AF via invented by us a “Clinical-Genetic riskometer of ischemic stroke in AF”.