Evaluation of haptoglobin phenotypes in acute myocardial infarction (AMI) and their association with some risk factors

Acute myocardial infarction (AMI) is one of the most common cardiovascular complications with a complex pathogenesis where inflammatory markers are involved in disease etiology. The aim of this study was to investigate haptoglobin phenotypes and their association with some risk factors in patients with a history of AMI. 120 patients who were referred to the emergency department of Amir Al Momenin hospital of Zahedan city, Zahedan-Iran were recruited in a cross-sectional case control study. 120 normal individuals were also chosen as controls for this study. Serum was isolated from routine bloods taken for diagnostic tests and used to determine haptoglobin phenotype distribution by electrophoresis. Phenotype differences as percent of phenotype frequency in patient and control groups were analysed using the χ² test and SPSS software. A high frequency of serum Hp2-2 haptoglobin phenotype in patients and healthy control were found (62.5% and 58.3% respectively). A meaningful statistical correlation between high frequency of Hp2-2 haptoglobin phenotype and AMI was not found (p value = 0.484). Whereas high frequency of Hp1-1 and HP2-2 phenotypes was associated with hyperlipidemia and hypertension respectively (p value = 0.01 and 0.04). Our results showed that there was a high frequency of Hp2-2 haptoglobin phenotype in patients as well as healthy controls in the population studies. High frequencies of Hp1-1and Hp2-2 phenotypes were associated with AMI in patients with hyperlipidemia and hypertension respectively. Thus these phenotypes in AMI patients may modulate the inflammatory response in combination with hyperlipidemia and hypertension.

phenotype, haptoglobin, acute myocardial infarction

1. Abbasi S.H., Kassaian S.E. Women and coronary artery disease. part i: basic considerations. J. Tehran Heart Cent., 2011, Vol. 6, no. 3, pp. 109-116.

2. Akbarzadeh Najar R., Ghaderian S.M., Tabatabaei Panah A.S. C-reactive protein (CRP) gene polymorphisms: implication in CRP plasma levels and susceptibility to acute myocardial infarction. Mol. Biol. Rep., 2012, Vol. 39, no. 4, pp. 3705-3712.

3. Aksoy S., Cam N., Gurkan U. Oxidative stress and severity of coronary artery disease in young smokers with acute myocardial infarction. Cardiol. J., 2012, Vol. 19, no. 4, pp. 381-386.

4. Biswas S., Ghoshal P., Mandel S. Relation of anti-to Pro-inflammatory cytokine Ratios with Acute myocardial infarction. Korean J. intern. Med., 2010, Vol. 25, pp. 44-50.

5. Bruyninckx R., Aertgeerts B., Bruyninckx P., Buntinx F. Signs and symptoms in diagnosing acute myocardial infarction and acute coronary syndrome: a diagnostic meta-analysis. Br. J. Gen. Pract., 2008, Vol. 58, no. 547, pp. 105-111.

6. Cesarino E.J., Vituzzo A.L., Sampaio J.M., Ferreira D.A., Pires H.A., de Souza L. Assessment of cardiovascular risk of patients with arterial hypertension of a public health unit. Einstein (São Paulo), 2012, Vol. 10, no. 1, pp. 33-38.

7. de Paula E.A., de Paula R.B., da Costa D.M., Colugnati F.A., de Paiva E.P. Cardiovascular risk assessment in hypertensive patients. Rev. Lat. Am. Enfermagem., 2013, Vol. 21, no. 3, pp. 820-827.

8. Diercks D.B., Peacock W.F., Hollander J.E., Singer A.J., Birkhahn R., Shapiro N., Glynn T., Nowack R., Safdar B., Miller C.D., Lewandrowski E., Nagurney J.T. Diagnostic accuracy of a point-of-care troponin I assay for acute myocardial infarction within 3 hours after presentation in early presenters to the emergency department with chest pain. Am. Heart J., 2012, Vol. 163, no. 1, pp. 74-80.e4.

9. Hong S.H., Kang B.Y., Lim J.H., Namkoong Y., Oh M.Y., Kim J.Q., Lee C.C. Haptoglobin polymorphism in Korean patients with cardiovascular diseases. Hum. Hered., 1997, Vol. 47, no. 5, pp. 283-287.

10. Ianni M., Callegari S., Rizzo A., Pastori P., Moruzzi P., Corradi D., Porcellini E., Campo G., Ferrari R., Ferrario Marco M., Bitonte S., Carbone I., Licastro F. Pro-inflammatory genetic profile and familiarity of acute myocardial infarction. Immun. Ageing., 2012, Vol. 9, no. 1, 14. doi: 10.1186/1742-4933-9-14.

11. Igland J., Vollset S.E., Nygård O.K., Sulo G., Ebbing M., Tell G.S. Educational inequalities in acute myocardial infarction incidence in Norway: a nationwide cohort study. PLoS ONE, 2014, Vo. 9, no. 9, e106898. doi: 10.1371/journal.pone.0106898.

12. Ijäs P., Saksi J., Soinne L., Tuimala J., Jauhiainen M., Jula A., Kähönen M., Kesäniemi Y.A., Kovanen P.T., Kaste M., Lindsberg P.J. Haptoglobin 2 allele associates with unstable carotid plaque and major cardiovascular events. Atherosclerosis, 201m Vol. 230, no. 2, pp. 228-234.

13. Khazaei H.A., Teymuri B., Nakhaei A., Mohammadi M., Noura M., Khazaei A., Tofiqh N., Rezaei N. Association of haptoglobin phenotypes with clinical features of preterm labor disease. Acta Med. Iran, 2013, Vol. 51, no. 8, pp. 554-559.

14. Lee C.W., Cheng T.M, Lin C.P., Pan J.P. Plasma haptoglobin concentrations are elevated in patients with coronary artery disease. PLoS ONE, 2013, Vol. 8, no. 10, e76817. doi: 10.1371/journal.pone.0076817.

15. Lee C.H., Cheng C.L., Yang Y.H., Chao T.H., Chen J.Y., Liu P.Y., Lin C.C., Chan S.H., Tsai L.M., Chen J.H., Lin L.J., Li Y.H. Trends in the incidence and management of acute myocardial infarction from 1999 to 2008: get with the guidelines performance measures in Taiwan. J. Am. Heart Assoc., 2014, Vol. 3, no. 4, pii: e001066. doi: 10.1161/JAHA.114.001066.

16. Levy A.P., Larson M.G., Corey D., Lotan R., Vita J.A., Benjamin E.J. Haptoglobin phenotype and prevalent coronary heart disease in the Framingham offspring cohort. Atherosclerosis, 2004, Vol. 172, no. 2, pp. 361-365.

17. Li Q., Wang Y., Wang Y., Chen K., Zhou Q., Wei W., Wang Y. Treg/Th17 Ratio Acts as a Novel Indicator for Acute Coronary Syndrome. Cell Biochem. Biophys., 201, Vol. 70, no. 2, pp. 1489-1498.

18. Lioupis C., Barbatis C., Drougou A., Koliaraki V., Mamalaki A., Klonaris C., Georgopoulos S., Andrikopoulos V., Bastounis E. Association of haptoglobin genotype and common cardiovascular risk factors with the amount of iron in atherosclerotic carotid plaques. Atherosclerosis, 2011, Vol. 216, no. 1, pp. 131-138.

19. Quaye I.K. Haptoglobin, inflammation and disease.Trans. R. Soc. Trop. Med. Hyg., 2008, Vol. 102, pp. 735-742.

20. Shrikhande S.N., Zodpey S.P., Negandhi H. A Case-control study examining association between infectious agents and acute myocardial infarction. Indian J. Public Health, 2014, Vol. 58, Iss. 2, pp. 106-109.

21. Simpson M., Snell-Bergeon J.K., Kinney G.L., Lache O., Miller-Lotan R., Anbinder Y., Rewers M.J., Levy A.P. Haptoglobin genotype predicts development of coronary artery calcification in a prospective cohort of patients with type 1 diabetes. Cardiovasc. Diabetol., 2011, Vol. 10, 99. doi: 10.1186/1475-2840-10-99.

22. Skoumas I., Masoura C., Aznaouridis K., Metaxa V., Tsokanis A., Papadimitriou L., Tousoulis D., Pitsavos C., Stefanadis C. Impact of cardiometabolic risk factors on major cardiovascular events in patients with familial combined hyperlipidemia. Circ. J., 2013, Vol. 77, no. 1, pp. 163-168.

23. Stillman A.E., Oudkerk M., Bluemke D . Assessment of acute myocardial infarction: current status and recommendations from the North American society for cardiovascular imaging and the European society of cardiac radiology. Int. J. Cardiovasc. Imaging, 2011, Vol. 27, no. 1, pp. 7-24.

24. Suleiman M., Aronson D., Asleh R., Kapeliovich M.R., Roguin A., Meisel S.R., Shochat M., Sulieman A., Reisner S.A., Markiewicz W., Hammerman H., Lotan R., Levy N.S., Levy A.P. Haptoglobin polymorphism predicts 30-day mortality and heart failure in patients with diabetes and acute myocardial infarction. Diabetes, 2005, Vol. 54, no. 9, pp. 2802-2806.

25. Sulo E., Vollset S.E., Nygård O., Sulo G., Igland J., Egeland G.M., Ebbing M., Tell G.S. Trends in 28-day and 1-year mortality rates in patients hospitalized for a first acute myocardial infarction in Norway during 2001-2009: a “Cardiovascular disease in Norway” (CVDNOR) project. J. Intern. Med., 2015, Vol. 277, no. 3, pp. 353-361.

26. Talaei M., Sarrafzadegan N., Sadeghi M., Oveisgharan S., Marshall T., Thomas G.N., Iranipour R. Incidence of cardiovascular diseases in an Iranian population: the Isfahan Cohort Study. Arch. Iran Med., 2013, Vol. 16, no. 3, pp. 138-144.

27. Tavares P., Oliveira A., Lopes C. Family history of coronary heart disease, health care and health behaviors. Rev. Port. Cardiol., 2011, Vol. 30, no. 9, pp. 703-710.

28. Tisminetzky M., McManus D.D., Gore J.M., Yarzebski J., Coles A., Lessard D., Goldberg R.J. 30-year trends in patient characteristics, treatment practices, and long-term outcomes of adults aged 35 to 54 years hospitalized with acute myocardial infarction. Am. J. Cardiol., 2014, Vol. 113, no. 7, pp. 1137-1141.

29. Vardi M., Levy A.P. Is it time to screen for the Haptoglobin genotype to assess the cardiovascular risk profile and vitamin E therapy responsiveness in patients with diabetes? Curr. Diab. Rep., 2012, Vol. 12, no. 3, pp. 274-279.

30. Wang X.H., Liu S.Q., Wang Y.L., Jin Y. Correlation of serum high-sensitivity C-reactive protein and interleukin-6 in patients with acute coronary syndrome. Genet. Mol. Res., 2014, Vol. 13, no. 2, pp. 4260-4266.

31. Xu F., Teng X., Yuan X., Sun J., Wu H., Zheng Z., Tang Y., Hu S. LCK: a new biomarker candidate for the early diagnosis of acute myocardial infarction. Mol. Biol. Rep., 2014, Vol. 41, no. 12, pp. 8047-8053.

32. Yu J., Mehran R., Grinfeld L., Xu K., Nikolsky E., Brodie B.R., Witzenbichler B., Kornowski R., Dangas G.D., Lansky A.J., Stone G.W. Sex-based differences in bleeding and long term adverse events after percutaneous coronary intervention for acute myocardial infarction: Three year results from the HORIZONS-AMI trial. Catheter. Cardiovasc. Interv., 2015, Vol. 85, no. 3, pp. 359-368.