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. 2014 Oct;38(3):380-7.
doi: 10.1007/s11239-014-1059-4.

Factor XIII Val34Leu polymorphism and recurrent myocardial infarction in patients with coronary artery disease

Rolf P Kreutz  1 , Abbas Bitar, Janelle Owens, Zeruesenay Desta, Jeffrey A Breall, Elisabeth von der Lohe, Anjan Sinha, Matteo Vatta, Perry Nystrom, Yan Jin, David A Flockhart
Affiliations

Factor XIII Val34Leu polymorphism and recurrent myocardial infarction in patients with coronary artery disease

Rolf P Kreutz et al. J Thromb Thrombolysis. 2014 Oct.

Abstract

Factor XIII (FXIII) is necessary for cross linking of fibrin strands and generation of stable fibrin clot. FXIII Val34Leu is a common genetic single nucleotide polymorphism that has been associated with accelerated fibrin stabilization and reduced rate of fibrinolysis. The contribution of Val34Leu to long term risk of recurrent myocardial infarction (MI) in patients with coronary stenting has not been conclusively established. The objective of the study was to examine the effects of Val34Leu on fibrin generation, platelet aggregation, and long term clinical outcomes in patients with coronary artery disease treated with dual antiplatelet therapy. Patients with angiographically documented coronary artery disease who were treated with aspirin and clopidogrel were enrolled (n = 211). Light transmittance aggregometry and plasma fibrin clot formation using thrombelastography (TEG) were determined. Genotyping of Val34Leu was performed using Taqman assay. Clinical events during follow up were recorded. Homozygous carriers of 34 Leu variant had significantly shorter fibrin clot formation time as compared to wild type individuals (TEG K: 1.27 ± 0.3 vs. 1.68 ± 1.1 min, p = 0.011). The Val34Leu variant was associated with gene dose dependent increased risk of MI (log rank, p = 0.002) or occurrence of composite of MI and CV death (log rank, p = 0.005) with highest event rates observed in homozygous carriers of 34 Leu. In summary, FXIII Val34Leu polymorphism was associated with increased rate of fibrin stabilization in homozygous carriers of the variant and may increase risk of recurrent MI and death in patients with angiographically established coronary artery disease treated with dual antiplatelet therapy.

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Conflict of interest statement

Disclosure YJ is currently an employee of Eli & Lilly, Co. The other authors have no conflicts of interest to declare.

Figures

Fig. 1
Fig. 1
Thrombelastography measurements grouped according to Val34Leu genotypes. a TEG-K: fibrin clot formation time. b TEG-angle. c TEG-G: maximal fibrin clot strength. d TEG-R: time to clot formation
Fig. 2
Fig. 2
Kaplan-Meier event free survival curves for cardiovascular death or myocardial infarction (a) and myocardial infarction alone (b), grouped according to Val34Leu genotypes
See this image and copyright information in PMC

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