PB0874 - The effect of PAI-1 gene polymorphism on the severity of acute coronary syndrome in patients with COVID-19

Background: In the context of COVID-19, the presence of genetic polymorphisms, such as the 4G/4G PAI-1 genotype, may contribute to the development of cardiovascular complications. COVID-19 has been associated with an increased risk of thrombotic events and myocardial injury. The 4G/4G genotype may additionally increase cardiovascular events risk in infected individuals.

Aims: To determine the effect of PAI-1 gene polymorphism on the severity of acute coronary syndrome (ACS) in patients with COVID-19.

Methods: This observational study included 24 age and gender matched patients. All patients received optimal medical treatment therapy (Table 1). The patients were divided into two groups - the study group consisted of patients with the 4G/4G gene polymorphism (6 patients), while the control group included patients with the 5G/5G and 5G/4G gene polymorphisms (18 patients). The severity of ACS was assessed by angiogram (Table 2). TIMI thrombus grade 4 and 5 were estimated as high thrombus burden. All patients signed Voluntary Informed Consent form. The study was approved by the Local Ethics Committee of the Ural State Medical University. Data processing was performed in “Statistica” software package.

Results: Despite the same treatment approach and the severity of COVID-19, patients with the 4G/4G gene polymorphism had significantly more numerous damaged vessels, higher thrombus burden, prolonged hospitalization compared to the control group. Thus, the presence of the 4G/4G PAI-1 gene polymorphism may increase the risk of coronary lesions, potentially exacerbating the course of ACS in patients with COVID-19.

Conclusion(s): Patients with 4G/4G PAI-1 gene polymorphism may have higher risk of coronary atherosclerosis and thrombosis, which can worsen the severity of ACS in the context of COVID-19. This highlights the importance of genetic factors investigation that may influence the development and progression of cardiovascular events in COVID-19 patients.