Connexin37 (GJA4) genotype predicts survival after an acute coronary syndrome

Background GJA4 1019 C > T, MMP3 −1171delA, and SERPINE1 −668delG genotypes have been associated with the risk of incident myocardial infarction. We tested the hypothesis that these genotypes would predict long-term mortality after an acute coronary syndrome (ACS). Methods We assembled a prospective cohort study on 726 patients with ACS admitted between March 2000 and October 2001. Kaplan-Meier estimates and Cox proportional hazards models of 3-year mortality adjusted for age, race, ACS type, prior heart failure, diabetes, and revascularization were used to compare groups. Results The GJA4 1019 C > T genotype was significantly related to mortality over 3 years (8.3% vs 14%, for the C/C vs T allele carriers; P = .02), with an adjusted hazard ratio of 1.7 (95% confidence interval 1.05-2.8, P = .03). This finding was consistent in both men and women (hazard ratio = 1.9 and 1.7, respectively) with no significant sex interaction (P = .8). The MMP3 −1171delA and SERPINE1 −668delG genotypes were not significantly related to mortality in the overall population (all P > .4). Conclusions GJA4 1019 C > T genotype predicted risk of death after an ACS, whereas the MMP3 and SERPINE1 genotypes did not. The GJA4 1019 C > T polymorphism may warrant integration into comprehensive risk stratification algorithms for patients with ACS.