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(Circulation. 1998;98:826-827.)
© 1998 American Heart Association, Inc.

Correspondence

Platelet Pl^A Polymorphism, Myocardial Infarction, and Extent of Coronary Artery Disease

Alberto Batalla, MD; Gustavo Iglesias Cubero, MD; Julián Rodriguez Reguero, MD; ; Eliecer Coto, MD

Servicio de Cardiología y Genética Molecular, Hospital Central de Asturias, Oviedo, Spain

To the Editor:

In a recent study published in your journal by Carter et al,¹ strong evidence was found of an association between the Pl^A2 allele of the glycoprotein IIb/IIIa gene and myocardial infarction in men younger than 47 years old. In addition, a relationship of this polymorphism with cholesterol levels and the extent of coronary artery disease was also observed in multivariate analyses.

Association of the Pl^A2 genotype and coronary disease is controversial. After the original study of Weiss et al² reporting an association of Pl^A2 and coronary disease, others failed to find the same association.^{3 4}

A study based on a population of 178 men younger than 50 years old and diagnosed with coronary disease was recently performed by our group in Spain. The prevalence of Pl^A2 was 24% in case subjects compared with 26% in age- and sex-matched control subjects. We also investigated whether the Pl^A2 allele was associated with other risk factors.⁵ We found that 43 patients who were Pl^A2 carriers showed significantly higher concentrations of LDL cholesterol. For the 43 patients (24%) with the Pl^A2 allele, LDL cholesterol was 4.3±1.9 mmol/L; for the 135 (76%) who had the Pl^A1A1 allele, LDL cholesterol was 3.7±0.9 mmol/L (P=0.02).

Finally, we agree with these authors that differences in Pl^A prevalence may represent either a type I statistical error or differences in the phenotype according to the studied populations. Furthermore, the association between high LDL cholesterol levels and the Pl^A2 allele could explain the relationship found between this . . . [Full Text of this Article]

Angela M. Carter, ; ; BSc Peter J. Grant, MD

Unit of Molecular Vascular Medicine, Research School of Medicine, University of Leeds, Leeds General Infirmary, Leeds, United Kingdom

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