First name and surname: Onwughara Prince Obinna
University: Sumy State University
City: Sumy
Country: Ukraine
Faculty: Medicine
E-mail: princeo2013@yahoo.com
Presenting author: Obinna Prince Onwughara
Title: Dr
Session: Cardiology and Cardiosurgery
Type: Orginal research
Abstract: Association of А69314G polymorphism of ТNАР gene in the patient with acute coronary syndrome with the modified risk factors

Introduction

![heart.jpg](https://cdn.steemitimages.com/DQmYUwZAYXiYBzrojwJs9x5biAzjSUfb5sh98zfQjhYHrJz/heart.jpg)![acute-coronary-syndrome.png](https://cdn.steemitimages.com/DQmZNcoeV9Q6rJD77wPgi2sXPxupsm3rhZEuzv2dZb4eTo4/acute-coronary-syndrome.png)Acute coronary syndrome is a term used to define insufficient blood supply to the heart. Let me use this opportunity to break down the anatomy of blood supply to us for better understanding of what the research is about. The heart can be explained to be a pump which supplies deoxygenated blood to the lung for oxygenation and later supplies the whole organs of the body with oxygen, we all have to know that the function of blood is to carry oxygen through binding protein call hemoglobin to organs of the body. The heart can also be described as an muscular organ located at the posterior mediastinum at the thoracic cavity, it has four(4) chambers namely; right atrium, left atrium, right ventricle and left ventricle![184px-Diagram_of_the_human_heart_(cropped).svg.png](https://cdn.steemitimages.com/DQmRBDTtasDEDUG7YySQm3BBRFroEjP8CcaP3deMo8g4U37/184px-Diagram_of_the_human_heart_(cropped).svg.png). Its function is to collect deoxygenated blood in the body and pump it to the lung through the pulmonary arteries to receive oxygen at the lung, after that blood enters back to the heart from pulmonary veins to the left part of the heart and start greater blood circulation from the left ventricle through the aorta to the whole body. Deoxygenated blood enters the right atrium of the heart from three main vessels; 1. The superior vena cava (drains the head trunk to the right atrium). 2. The inferior vena cava (drains the whole lower limb to the right atrium) and 3. The coronary sinus (which collects drainage of blood supply to the heart as an organ and is tributary to right atrium), blood then moves to the right ventricle from the right atrium and continues to the pulmonary trunk which later becomes pulmonary arteries and runs into the helium of the lung in its sequences at both lungs. At the lung, the blood carries oxygen and through the four(4) pulmonary veins it moves to the left atrium which continues to the left ventricle, when the left ventricle contracts the blood pumps through the aorta and starts circulating to the body.. NOTE THAT just as other organs requires blood supply in order to function well, the heart also receives blood supply as an organ from the coronary arteries. Now, haven gotten some hint on the blood supply and how it works, Acute coronary syndrome arises when there is obstruction in the coronary artery which supplies the heart blood in order for it to function well![presentation.jpg](https://cdn.steemitimages.com/DQma9JraQNctCb2bghRAHACuRyHqRKGdjiCd3xH4Nb1y8Bc/presentation.jpg). Obstruction of coronary artery can arise as a result of blood clot, embolism, trauma, obesity, aging and so on. It manifests as angina which radiates to the scapular or the arm. Today, my research is about the Tissue nonspecific alkaline phosphatase (ТNАР) – protein, playing significant role in the tissue mineralization![image001.gif](https://cdn.steemitimages.com/DQmZCg8cdnHX7nrNWSWDVXYpH7rrjhKnW9VALW1A95NQspR/image001.gif).ТNАР belongs to the activators of the calcification processes in the atherosclerotic plaque. Complicated plaque rupture of the coronary vessels leads to the organ’s ischemia and development of acute coronary syndrome (ACS).
Aim. To conduct the analysis of the connection of А69314G of the gene polymorphism ТNАР in the sick people with ACS with some modified risk factors.
Materials and methods. The dark blood of the 118 sick people with ACS and of 110 almost healthy people was used. Distinguishing of the А69314G polymorphism was conducted with the help of the method of polymerase chain reaction with the further analysis of the restriction fragments’ length.
Results of the research. In the patients with the body mass index (BMI) < 25 kg/m2 the connection between the various genotypes according to the А69314G polymorphism and development of ACS (χ2=0.027; P=0.869) was not revealed. In the individuals with BMI ≥ 25 kg/м2group of control the frequency of the genotypes (А/А, А/G+G/G) comprised 85.9 and 14.1% and in the patients with ACS – 68.0 і 32.0% (χ2=7.558; P=0.006).
In homozygotes with the A/A main allele there is no connection between the size of the BMI and development of ACS (χ2=1.413; P=0.235). The number of patients with A/G + G/G genotype and the BMI < 25 and the BMI ≥ 25 kg/m2 in control group was 38.9 and 61.1% and number of patient with ACS – 13.9 and 86.1% (χ2=4.339; P=0.037).
During the analysis of the influence of the allele variants with А69314G polymorphism on the BMI, depending on the stage of obesity in the patients with ACS the authentic statistical significance was not revealed (χ2=2.467, Р=0.481).
In those, who do not smoke, there is no connection of the examined polymorphism with the development of ACS (χ2=1.831; P=0.176). Among the smokers the frequency of genotypes А/А and А/G+G/G in the control group comprised 86.2 and 13.8% and among the patients with ACS – 64.8 and 35.2% (χ2=4.310; P=0.038). Among the individuals with A/A genotype the correlation of the smokers and non-smokers in the control group comprised 72.8 and 27.2%, and in the patients with ACS – 57.3 and 42.7% (χ2=4.616; P=0.032). In the patients with А/G+G/G genotype those who smoke and those who do not smoke in the control group there were 77.8 and 22.2%, and among the patients with ACS – 47.2 and 52.8% (χ2=4.582; P=0.032).
Conclusion. In the patients with the BMI ≥ 25 kg/m2 there is connection of А69314G polymorphism of TNAP gene with the development of ACS. ACS risk in the patients with А/G+G/G genotype is higher than with А/А genotype. In the smokers with А/G+G/G genotype the risk of ACS is higher than in the individuals with A/A genotype.