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Int J Med Sci 2024; 21(3):483-491. doi:10.7150/ijms.89901 This issue Cite

Research Paper

Transcription factor 21 rs12190287 polymorphism is related to stable angina and ST elevation myocardial infarction in a Chinese Population

Teng-Hung Yu^1,2, Thung-Lip Lee^1,3, I-Ting Tsai^2,4, Chin-Feng Hsuan^1,2,5, Chao-Ping Wang^1,3, Yung-Chuan Lu^3,6, Wei-Hua Tang^7,8, Ching-Ting Wei^9,10, Fu-Mei Chung¹, Yau-Jiunn Lee¹¹, Cheng-Ching Wu^1,2,12,✉

1. Division of Cardiology, Department of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung 82445 Taiwan.
2. School of Medicine, College of Medicine, I-Shou University, Kaohsiung, 82445 Taiwan.
3. School of Medicine for International Students, College of Medicine, I-Shou University, Kaohsiung, 82445 Taiwan.
4. Department of Emergency, E-Da Hospital, I-Shou University, Kaohsiung 82445 Taiwan.
5. Division of Cardiology, Department of Internal Medicine, E-Da Dachang Hospital, I-Shou University, Kaohsiung 807066, Taiwan.
6. Division of Endocrinology and Metabolism, Department of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung 82445 Taiwan.
7. Division of Cardiology, Department of Internal Medicine, Taipei Veterans General Hospital, Yuli Branch, Hualien 98142 Taiwan.
8. Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei 112304 Taiwan.
9. Division of General Surgery, Department of Surgery, E-Da Hospital, I-Shou University, Kaohsiung 82445 Taiwan.
10. The School of Chinese Medicine for Post Baccalaureate, College of Medicine, I-Shou University, Kaohsiung 82445 Taiwan.
11. Lee's Endocrinologic Clinic, Pingtung 90000 Taiwan.
12. Division of Cardiology, Department of Internal Medicine, E-Da Cancer Hospital, I-Shou University, Kaohsiung 82445 Taiwan.

✉ Corresponding author: Dr. Cheng-Ching Wu; E-Da Hospital, I-Shou University, No. 1, Yi-Da Rd., Jiau-Shu Village, Yan-Chao Township, Kaohsiung, 82445, Taiwan; Tel: +886-7-615-1100 ext. 5914 or 5018; E-mail: maxvic24isu.edu.tw.

Abstract

Background: Transcription factor 21 (TCF21, epicardin, capsuling, pod-1) is expressed in the epicardium and is involved in the regulation of cell fate and differentiation via epithelial-mesenchymal transformation during development of the heart. In addition, TCF21 can suppress the differentiation of epicardial cells into vascular smooth muscle cells and promote cardiac fibroblast development. This study aimed to explore whether TCF21 gene (12190287G/C) variants affect coronary artery disease risk.

Methods: We enrolled 381 patients who had stable angina, 138 with ST elevation myocardial infarction (STEMI), and 276 healthy subjects. Genotyping of rs12190287 of the TCF21 gene was performed.

Results: Higher frequencies of the CC genotype were found in the patients with stable angina/STEMI than in the healthy controls. After adjusting for diabetes mellitus, hypertension, age, sex, smoking, body mass index and hyperlipidemia, the patients with the CC genotype of the TCF21 gene were associated with 2.49- and 9.19-fold increased risks of stable angina and STEMI, respectively, compared to the patients with the GG genotype. Furthermore, TCF21 CC genotypes showed positive correlations with both stable angina and STEMI, whereas TCF21 GG genotypes exhibited a negative correlation with STEMI. Moreover, the stable angina and STEMI patients with the CC genotype had significantly elevated high-sensitivity C-reactive protein levels than those with the GG genotype. In addition, significant associations were found between type 2 diabetes mellitus, hypertension, and hyperlipidemia with TCF21 gene polymorphisms (p for trend < 0.05).

Conclusion: TCF21 gene polymorphisms may increase susceptibility to stable angina and STEMI.

Keywords: transcription factor 21, polymorphism, stable angina, ST elevation myocardial infarction

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