Haptoglobin Polymorphism Predicts 30-Day Mortality and Heart Failure in Patients With Diabetes and Acute Myocardial Infarction

• Published in: Diabetes (New York, N.Y.) Vol. 54; no. 9; pp. 2802 - 2806
• Main Authors: SULEIMAN, Mahmoud, ARONSON, Doron, HAMMERMAN, Haim, LOTAN, Rachel, LEVY, Nina S, LEVY, Andrew P, ASLEH, Rabea, KAPELIOVICH, Michael R, ROGUIN, Ariel, MEISEL, Simcha R, SHOCHAT, Michael, SULIEMAN, Abeer, REISNER, Shimon A, MARKIEWICZ, Walter
• Format: Journal Article
• Language: English
• Published: Alexandria, VA American Diabetes Association 01.09.2005
• Subjects: Biological and medical sciences; Cardiology. Vascular system; Coronary heart disease; Diabetes; Diabetes Mellitus - physiopathology; Diabetes. Impaired glucose tolerance; Diabetics; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Genetic aspects; Genotype; Haptoglobin; Haptoglobins - genetics; Heart; Heart attack; Heart attacks; Heart failure; Heart failure, cardiogenic pulmonary edema, cardiac enlargement; Hemoglobin; Humans; Hypotheses; Logistic Models; Medical prognosis; Medical sciences; Mortality; Multivariate Analysis; Myocardial Infarction - genetics; Myocardial Infarction - mortality; Myocarditis. Cardiomyopathies; Observations; Odds Ratio; Phenotype; Polymorphism; Polymorphism, Genetic; Prognosis; Prospective Studies; Regression analysis; Risk factors; Time Factors; United States; Endocrinopathy; Human; Myocardial infarction; Heart failure; Heart disease; Diabetes mellitus; Mortality; Cardiovascular disease; Myocardial disease; Polymorphism
• ISSN: 0012-1797; 1939-327X
• DOI: 10.2337/diabetes.54.9.2802

Haptoglobin Polymorphism Predicts 30-Day Mortality and Heart Failure in Patients With Diabetes and Acute Myocardial Infarction Mahmoud Suleiman 1 , Doron Aronson 1 , Rabea Asleh 2 , Michael R. Kapeliovich 1 , Ariel Roguin 1 , Simcha R. Meisel 1 , Michael Shochat 1 , Abeer Sulieman 2 , Shimon A. Reisner 1 , Walter Markiewicz 1 , Haim Hammerman 1 , Rachel Lotan 2 , Nina S. Levy 2 and Andrew P. Levy 2 1 Department of Cardiology, Rambam Medical Center, Haifa, Israel 2 Technion Faculty of Medicine, Haifa, Israel Address correspondence and reprint requests to Andrew P. Levy MD, PhD, FACC, Technion Faculty of Medicine, Rappaport Building, Bat Galim, Haifa, 31096, Israel. E-mail: alevy{at}tx.technion.ac.il Abstract Patients with diabetes presenting with acute myocardial infarction (AMI) have an increased rate of death and heart failure. Patients with diabetes homozygous for the haptoglobin (Hp) 1 allele (Hp 1-1) develop fewer vascular complications. We tested the hypothesis that Hp type is related to the outcome of patients with diabetes presenting with AMI. We prospectively assessed the relationship between Hp type and 30-day mortality and heart failure in 1,437 patients with AMI (506 with diabetes). Multivariate logistic regression identified a significant interaction between Hp type and diabetes status on these outcome measures. Hp type was not related to outcome among patients without diabetes. In contrast, Hp 1-1 was associated with a strong protective effect with regard to the primary end point of death (OR 0.14, P = 0.015) and for death and heart failure (OR 0.35; 95% CI 0.15–0.86, P = 0.018) among patients with diabetes. Finally, among patients with diabetes, Hp 1-1 was associated with smaller infarct size. This study demonstrates that in patients with diabetes and AMI, the Hp type is an important determinant of clinical outcome and infarct size. AMI, acute myocardial infarction Hp, haptoglobin Footnotes M.S. and D.A. contributed equally to this study. A.P.L. has served on the advisory board of, holds stock in, and has received honoraria from Haptoguard. Accepted May 23, 2005. Received February 20, 2005. DIABETES