Risk of Myocardial Infarction and Polymorphisms in Candidate Genes

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Abstract
Yamada et al. (Dec. 12 issue)1 state that the identification of genotypes of the 4G–668/5G polymorphism of the gene encoding plasminogen-activator inhibitor type 1 may be a reliable means of predicting the risk of myocardial infarction in women. We performed a matched case–control study of the polymorphism in 298 Italian women, half of whom had had a first myocardial infarction before the age of 45 years; the others were healthy members of the hospital staff. This population was chosen because there is usually little coronary atherosclerosis among premenopausal women, in whom it is therefore biologically plausible that myocardial infarction is related to a genetic predisposition to thrombosis. Analysis of the association of the 4G–668/5G polymorphism with the risk of myocardial infarction, which gave an odds ratio of 1.6 (95 percent confidence interval, 1.2 to 2.1; P2 that at least in white men and women, there is still no genetic marker that can be clinically used to predict myocardial infarction.