Zikai Song, Hongyan Cao, Ling Qin, and Yanfang Jiang. 1. Introduction

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1 BioMed Reserch Interntionl Volume 2013, Article ID , 7 pges Reserch Article A Cse-Control Study between Gene Polymorphisms of Polyunsturted Ftty Acid Metbolic Rte-Limiting Enzymes nd Acute Coronry Syndrome in Chinese Hn Popultion Ziki Song, Hongyn Co, Ling Qin, nd Ynfng Jing Deprtment of Crdiology, the Second Division of the First Hospitl, Jilin University, 3302 JiLin Street, Chngchun , Chin Correspondence should be ddressed to Ling Qin; qinling@medmil.com.cn nd Ynfng Jing; ynfngjing@hotmil.com Received 5 September 2012; Accepted 14 Jnury 2013 Acdemic Editor: Joseph Fomusi Ndisng Copyright 2013 Ziki Song et l. This is n open ccess rticle distributed under the Cretive Commons Attribution License, which permits unrestricted use, distribution, nd reproduction in ny medium, provided the originl work is properly cited. The purpose of this study is to nlyze the reltionship between the polymorphisms of ftty cid desturse 1 (FADS1), ftty cid desturse 2 (FADS2), nd elongtion of very long-chin ftty cids-like 2 (ELOVL2) nd cute coronry syndrome (ACS) in Chinese Hn popultion. Therefore, we selected three single nucleotide polymorphisms (SNPs) from these cndidte genes nd genotyped them using PCR-bsed restriction frgment length polymorphism nlysis in 249 ACS ptients nd 240 non-acs subjects, s were Hn Chinese ncestry. The results showed tht rs in the FADS1 gene is found to be in llelic ssocition (P = 0.003) nd genotypic ssocition (P = 0.036) with ACS. The frequencies of rs minor llele (T) in cse group were obviously higher thn in control group. The trns-phse gene-gene interction nlysis showed tht the combined genotype of rs (T/T) nd rs (T/T) ws ssocited with ACS (P = 0.031). And the results suggest tht, for rs C>T, the CT/TT genotypes were more likely to led in ACS in subjects with hypertension fter correction of ll risk fctors (OR = 4.236, 95% CI, ). These findings suggest tht the polymorphisms of rs in the FADS1 gene re very likely to be ssocited with ACS in Chinese Hn popultion, especilly in subjects with hypertension. 1. Introduction Acute coronry syndrome (ACS) is common disese, nd mjor determinnt of morbidity nd mortlity in ll rces, ethnicities, nd cultures [1], which is cused by combintion of genetic bckground nd environmentl fctors. The epidemic of coronry rtery disese (CAD), especilly its mnifesttion s ACS, is globl issue tht ccounts for more thn 80% of the burden of this disese in developing countries [2] nd results in pproximtely 30% of ll deths worldwide ech yer [3]. The spectrum of ACS rnges from unstble ngin pectoris (UAP) to cute myocrdil infrction (AMI), including ST-segment elevtion myocrdil infrction (STEMI) nd non-stemi (NSTEMI) [4]. Atherosclerotic plque instbility is the min feture of ACS pthogenesis. Blood nd tissue contents of polyunsturted ftty cid (PUFA) nd long-chin PUFA (LC-PUFA) re relted to numerous helth outcomes including crdiovsculr helth, llergies, mentl helth, nd cognitive development [5]. There re two fmilies of PUFA, nd they re clssified s omeg- 3(n-3)ndomeg-6(n-6)bsedontheloctionofthe lst double bond reltive to the terminl methyl end of the molecule [6]. Evidence from vrious reserch prdigms supports the crdiovsculr benefits of high intke of n- 3 polyunsturted ftty cids (PUFAs), especilly the longchin, mrine-derived n-3 PUFA, eicospentenoic cids, nd docoshexenoic cids [7, 8]. And n-6 PUFA re well knownfortheircriticlroleinmnyphysiologiclfunctions ndseemtoreducerisksofcad[9]. Both fmilies of ftty cids, n-3 nd n-6, shre nd compete for the sme enzymes (Δ6-desturse, Δ5-desturse, nd elongses) in their biosynthesis, nd Δ6-desturse is the rte-limiting step [10 12]. Δ5-desturse (D5D) nd Δ6-desturse (D6D) re encoded by the genes FADS1 nd FADS2, respectively, which form gene cluster jointly with the gene for ftty cid desturse 3 (FADS3) on the humn chromosome 11q12-q13.1 [12, 13]. And D5D nd D6D minly involved in regulting the levels of proinflmmtory nd

2 2 BioMed Reserch Interntionl nti-inflmmtory eicosnoids derived from PUFAs [14]. Additionlly, nother essentil enzyme, elongse, is involved in the homeostsis of longer chin n-3 ftty cids, which is encoded by elongtion of very long-chin ftty cids-like 2 (FEN1/Elo2, SUR4/Elo3, yest) (ELOVL2) gene[15]. Polymorphisms in the genes FADS1 nd FADS2 re ssocited with n-3 nd n-6 ftty cid levels nd especilly with rchidonic cid (ARA) mounts in blood nd severl tissues [16 22]. The presence of vrint T to deletion (T-del) in the promoter of the Δ6-desturse gene (FADS2)leds to reduced timnodonic cid (EPA) concentrtions in plsm nd dipose tissue [18], suggesting tht this vrint decreses enzyme ctivity nd therefore conversion from ALA. The presence of the FADS2 T-del vrint is lso ssocited with higher plsm triglyceride concentrtions [18]. Additionlly, number of studies hve reported significnt ssocitions between FADS genotypes nd the risk of CAD [23, 24]. In CHIANTI study, the genome-wide ssocition study (GWAS) showed tht the strongest evidence for ssocition ws observed in region of chromosome 11 tht encodes three ftty cid desturses (FADS1, FADS2, nd FADS3) [25]. In 2010, nother lrge GWAS repeted the strongest ssocition between FADS1 nd ELOVL2 genes nd the rtio of product to precursor ftty cids [26]. Severl studies, including recent met-nlysis of genome-wide ssocition (GWA) scns, confirmed tht polymorphisms in the FADS gene cluster were ssocited with PUFA concentrtions in serum phospholipids nd erythrocyte cell membrnes in severl popultions, including Cucsins, Est Asins, nd Africn Americns [19, 23, 25, 27 29]. Untilnow,itisunknownwhetherornotSNPsinthe FADS1/FADS2 gene cluster nd ELOVL2 gene re ssocited with ACS in Chinese Hn popultion. The im of this study ws to investigte the possible ssocition between the gene SNPs of PUFA metbolic rte-limiting enzymes nd risk of ACS in Chinese Hn popultion through the cse-control study continingfads1/fads2 nd ELOVL2genes. 2. Subjects nd Methods 2.1. Study Subjects. This cse-control study included 249 ACS ptients nd 240 controls in order to undertke genetic nlysis for ssocition between the PUFA rte-limiting enzymes gene polymorphisms nd ACS. All ptients used for this study were Chinese of Hn descent. Ptients with ACS were dmitted to the First Hospitl of Jilin University, Chngchun, Chin, in the period between 2008 nd All subjects gve written informed consent for the study. The study ws pproved by the ethics committee of Jilin University, Chngchun, Chin. Dignosis ws crried out independently by t lest two well-trined physicins bsed on the following criteri. All ptients (143 mles nd 106 femles) were identified with ACS by coronry computed tomogrphic ngiogrphy (SIEMNS Somtom Definition AS row spirl CT). ACS ws defined by 75% stenosis in ny mjor coronry rtery. Acute coronry syndrome encompsses three clinicl dignoses: unstble ngin, non-st-segment elevtion myocrdil infrction, nd ST-segment elevtion myocrdil infrction. Myocrdil infrction with crdic chest pin, serologic evidence of myonecrosis, nd persistent (>20 min) ST-segment elevtion ws confirmed s WHO criteri issued in 1979 [30]; the definition of UAP is when crdic chest pin ws new or worsening without serologic evidence of myonecrosis (i.e., no elevtion of serum troponin or cretine kinse MB isoenzyme concentrtion), or dynmic electrocrdiogrphic (ECG) chnges (i.e., ST depression nd/or T wve inversion); the definition of NSTEMI is when the ptient hd crdic chest pin nd serologic evidence of myocrdil necrosis in the bsence of ST-segment elevtion on the ECG [31], nd ptients with nontherosclerotic vsculr diseses, congenitl hert disese, crdiomyopthy, vlvulr disese, renl or heptic disese, nd cncer were excluded. Bsed on the principle of epidemiology for setting control group [32], control group contined 240 helthy ptients (126 mles nd 114 femles) rndomly selected from the sme geogrphicl re who were undergoing routine checkup s prt of nnul physicl exmintion, which included n ECG, chest X-ry, nd serum nlysis. The control group ws formed on the bsis of their unremrkble physicl exmintion, s well s the bsence of personl or fmily history nd resons to suspect ACS. The presence of crdiovsculr risk fctors, including dibetes mellitus, blood pressure, nd cigrette smoking, ws obtined from ll prticipnts. Dignosis of hypertension nd dibetes mellitus ws performed ccording to World Helth Orgniztion criteri. In this study, hypercholesterolemi ws defined s serum totl cholesterol level of 200 mg/dl or more, nd smoking hbit ws defined s dily intke of >10 cigrettes [4]. Overnight fsting venous blood smples were collected from ll subjects for genomic DNA extrction Genotyping. Three SNPs rs (Mbo I site) in the FADS1, rs (Msp I site) in the FADS2, ndrs (Hh I site) in the ELOVL2 were selected s genetic mrkers. They were ll C to T bse chnge present in intron. SNP informtion ws obtined from NCBI dbsnp Build 132 ( The cndidtes SNPs were restricted to minor llele frequency bigger thn 15% in HAPMAP-CHB dtbse ( Genomic DNA used for PCR mplifiction ws extrcted from the whole blood smple using DNA extrction kit (Promeg, Beijing, Chin). SNPs were genotyped using stndrd polymerse chin rection nd restriction frgment length polymorphism (RFLP) nlysis. The sequences of primers for mplifiction re vilble s follows (Tble 1). PCR conditions included predenturtion t 94 C for 5 minutes followed by 35 cycles of 95 C for seconds, Cfor1minutes,nd72 Cfor1minutes,ndfinl extension t 72 Cfor10minutes Sttisticl Anlysis. Dt were expressed s percentges of totl ctegoricl vribles, or men ± SD. The sttisticl nlyses on the chrcteristics of the subjects were performed with Person χ 2 test for the ctegoricl vribles such s sex, smokers, nd nonnorml distribution vrible ge ws compred by Mnn-Whitney rnk sum test.

3 BioMed Reserch Interntionl 3 Tble 1: The sequences of primers for mplifiction. Genes SNPs Primers Sequences FADS1 rs Forwrd 5 AAGCAGGGACCTCAAGAC3 Reverse 5 AGCCCACCAAGAATGTAA3 FADS2 rs Forwrd 5 GAACTGTCAGAGGCAACG3 Reverse 5 CTGGGCAATAAAGCAAGA3 ELOVL2 rs Forwrd 5 CCCTTTGTGCGAGAACCT3 Reverse 5 ATCCCAAGCGACAGACCC3 Tble 2: Generl chrcteristics of ptients nd controls included in our study. Subject chrcteristics Cse Control (n = 249) (n = 240) P vlue Age (yers) ± ± Mle, n (%) 143 (57.4) 126 (52.5) Dibetes, n (%) 86 (34.5) 30 (14.4) <0.001 Hypertension, n (%) 154 (61.8) 96 (40.0) <0.001 Smokers, n (%) 162 (65.1) 86 (35.8) <0.001 Medin ± QR. Age ws compred by using Mnn-Whitney rnk sum test. Mle, dibetes, hypertension, nd smokers were compred by using Person s Chi-squre test. The Hrdy-Weinberg equilibrium for the genotypic distributions of SNPs ws tested using the Chi-squre (χ 2 ) goodness-of-fit test. The Hploview progrm (version 4.1) ws pplied to estimte the linkge disequilibrium (LD) mesures (D nd r 2 ) between pired SNPs. Allelic ssocition, genotypic ssocition, nd nlysis for gene-gene interction were performed with the UNPHASED progrm, which is n ppliction for performing genetic ssocition nlysis in nucler fmilies nd unrelted subjects [21]. Results re expressed s odds rtio (OR) nd 95% confidence intervls (CI). P vlues < 0.05 were considered significnt. With regrd to the gene-gene interction tests, the genotypes with reltive frequencies of less thn 3% were not considered for nlysis. We lso pplied the permuttion test (1000 times) performed with UNPHASED to correct the finl P vlues for the mrkers used. 3. Results 3.1. Chrcteristics of Study Subjects. Tble 2 lists the demogrphic nd clinicl chrcteristics of the 249 ACS ptients nd 240 control subjects. Compred with control group, ACS group hd more mles, more smokers, nd more individuls with dibetes. However, there ws no significnt difference of the men ge nd proportion of hypertension between cse nd control groups Allele nd Genotype Anlysis. Rs of FADS1, rs of FADS2, nd rs of ELOVL2 were genotyped,ndtheyllliewithinintron.rs174556ndrs locte in different LD block on 11q12-q13.1 region (D = 0.57, r 2 = 0.52). Rs loctes on 6p24.2. The χ 2 goodness-of-fit test showed tht the genotypic distributions of rs174556, rs174617, nd rs were not devited from Hrdy-Weinberg equilibrium in both cse nd control groups (P > 0.05). Tbles 3 nd 4 present the distributions of lleles nd genotypes of 3 SNPs mong prticipnts, respectively. For rs174556, C ws mjor llele, frequency ws 60.6% nd 69.6% in cse nd control group, respectively, but for rs nd rs , T ws mjor llele. Anlysis with the UNPHASED softwre showed tht rs ws ssocited with ACS before (χ 2 = 8.592, P= 0.003) nd fter 1000 permuttion test (P = ), nd frequencyofminorlleletofrs174556wssignificntly higher in cse thn control subjects (Tble 3). However, rs nd rs were not ssocited with ACS. As shown in Tble 4, the logistic regression nlysis test reveled genotypic ssocition between rs nd ACS fter being djusted for confounding fctors (χ 2 = 6.084, P = 0.036), but not the genotypic ssocition ws observed between the other 2 SNPs nd ACS. We further nlyzed the ssocitions between the polymorphisms of three SNPs nd ACS for subgroups with or without hypertension, DM, nd smoking. The results suggest tht, for rs C>T, compred with the CC genotype, thect/ttgenotypesweremorelikelytoresultinacsin subjects with hypertension fter correction of ll risk fctors (OR=4.236, 95% CI, ) (Tble 5). Wheres, nother two SNPs, rs nd rs , were not ssocited with ACS fter correction of ll risk fctors (Tble 6) Trns-Phse Gene-Gene Interction Anlysis. In Tble 7, the combined genotypes for rs nd rs with frequency more thn 3% re presented. We used the most commonly combined genotype mjor homozygote s reference, nd the results showed tht ELOVL2 gene hd combined effect with FADS1 gene (χ 2 = , df=6,p= 0.028). Rs (C/C)-rs (T/T) nd rs (T/T)- rs (T/T) were ssocited with ACS (χ 2 = 4.478, P= 0.034, χ 2 = 4.656, P = 0.031) Logistic Regression Anlysis. As shown in Tble 8, ccording to multivrite logistic regression nlysis, the most predictive risk fctor for ACS ws hypertension, followed by smoking, dibetes, nd the T llele in rs The T llele in rs my be risk fctor for ACS (OR = 1.791, 95% CI, ).

4 4 BioMed Reserch Interntionl Tble 3: Distribution of llele frequencies of SNPs in cse nd control groups. Genes SNPs Allele Cse (%) Control (%) χ 2 P OR 95% CI FADS1 rs C 302 (60.6) 334 (69.6) T 196 (39.4) 146 (30.4) FADS2 rs T 386(77.5) 380(79.2) C 112 (22.5) 100 (20.8) ELOVL2 rs T 368 (73.9) 372 (77.5) C 130 (26.1) 108 (22.5) The djusted P vlue ws from 1000 permuttions. Tble 4: Distribution of genotype frequencies of SNPs in cse nd control groups. Genes SNPs Genotype Cse (%) Control (%) χ 2 P OR 95% CI C/C 96 (38.6) 119 (49.6) FADS1 rs C/T 110 (44.2) 96 (40.0) T/T 43 (17.3) 25 (10.4) T/T 148 (59.4) 149 (62.1) FADS2 rs C/T 90 (36.1) 82 (34.2) C/C 11 (4.4) 9 (3.8) T/T 141 (56.6) 145 (60.4) ELOVL2 rs C/T 86 (34.5) 82 (34.2) C/C 22 (8.8) 13 (5.4) Adjustment for ge, sex, nd the presence of dibetes, hypertension, nd smoking by forwrd logistic regression nlysis. Tble 5: Strtified nlysis between the rs C>T polymorphisms nd risk of ACS by hypertension, DM, nd smoking. Cse (n = 249) Control(n = 240) AdjustedOR(95%CI) CC (%) CT + TT (%) CC (%) CT + TT (%) CC CT + TT Rs C>T genotypes Hypertension No 24 (25.3) 71 (74.7) 43 (29.9) 101 (70.1) ( ) Yes 72 (46.8) 82 (53.2) 76 (79.2) 20 (20.8) ( ) DM No 26 (16.0) 137 (84.0) 101 (48.1) 109 (51.9) ( ) Yes 70 (81.4) 16 (18.6) 18 (60.0) 12 (40.0) ( ) Smoking No 10 (11.5) 77 (88.5) 49 (31.8) 105 (68.2) ( ) Yes 86 (53.1) 76 (46.9) 70 (81.4) 16 (18.6) ( ) No 3 risk 10 (16.1) 52 (83.9) 36 (32.1) 76 (67.9) ( ) Ajusted for ge, sex, nd the presence of dibetes, hypertension, nd smoking sttus except the strtified fctor t ech strtum. 4. Discussion FADS1, FADS2, nd ELOVL2 ll encode rte-limiting enzymes in PUFA metbolism. And mny studies hve confirmed tht high levels of PUFA in plsm phospholipids, cell membrnes, or whole blood were ssocited with lower risk of multiple diseses, including metbolic syndrome, CAD, et l. Therefore, we investigte the ssocition between the common vrints of the three genes nd ACS. Our results show tht the frequency of minor llele T of rs ws remrkbly higher in cse thn control group (P = 0.003), s the frequency of TT genotype of rs in cse group ws lso mrkedly higher thn in control group (P = 0.036). And for rs C>T, compred with the CC genotype, the CT/TT genotypes were more likely to led to ACS in subjects with hypertension fter correction of ll fctors. Rs in the FADS2 ws not ssocited with ACS. Bsedonourresults,therefore,rs174556intheFADS1 hs significnt role in the development of ACS, especilly in subjects with hypertension. But the locus rs is not functionl SNP, which locted in intron of FADS1 gene. As result, we infer tht the FADS1 gene my confer susceptibility of ACS through ffecting nerby gene. Mny studies lso hve proved tht SNPs in FADS1/FADS2 were ssocited with plsm lipid concentrtions in dult popultions nd children [33, 34]. However, in contrst with our results, Aslibekyn

5 BioMed Reserch Interntionl 5 Tble 6: Strtified nlysis between the rs nd rs T>C polymorphisms nd risk of ACS by hypertension, DM, nd smoking. Cse (n = 249) Control(n = 240) AdjustedOR(95%CI) TT (%) CC + CT (%) TT (%) CC + CT (%) TT CC + CT Rs T>C genotypes Hypertension No 51 (58.0) 37 (42.0) 109 (75.7) 35 (24.3) ( ) Yes 90 (58.4) 64 (41.6) 40 (41.7) 56 (58.3) ( ) DM No 88 (54.0) 75 (46.0) 135 (64.3) 75 (35.7) ( ) Yes 60 (69.8) 26 (30.2) 14 (46.7) 16 (53.3) ( ) Smoking No 58 (82.8) 29 (17.2) 113 (73.4) 41 (26.6) ( ) Yes 90 (46.9) 72 (53.1) 36 (41.9) 50 (58.1) ( ) No 3 risk 50 (71.4) 20 (28.6) 60 (65.2) 32 (34.8) ( ) Rs T>C genotypes Hypertension No 67 (70.5) 28 (29.5) 115 (79.9) 29 (20.1) ( ) Yes 74 (48.1) 80 (51.9) 30 (31.2) 66 (68.8) ( ) DM No 89 (16.0) 74 (84.0) 125 (59.5) 85 (40.5) ( ) Yes 52 (60.5) 34 (39.5) 20 (66.7) 10 (33.3) ( ) Smoking No 59 (11.5) 28 (88.5) 105 (31.8) 49 (68.2) ( ) Yes 82 (53.1) 80 (46.9) 40 (81.4) 46 (18.6) ( ) No 3 risk 60 (85.7) 10 (14.3) 80 (74.1) 28 (25.9) ( ) Ajusted for ge, sex, nd the presence of dibetes, hypertension, nd smoking sttus except the strtified fctor t ech strtum. Tble 7: The trns-phse nlysis for genotypic combined effect in cse nd control groups. Combined genotype Cse Control χ 2 P OR (95% CI) rs (C/C)-rs (T/T) referent rs (C/C)-rs (C/T) ( ) rs (C/T)-rs (C/T) ( ) rs (C/T)-rs (T/T) ( ) rs (T/T)-rs (T/T) ( ) Test of overll ssocition: χ 2 =14.112,df=6,P = Only listed the combined genotypes with frequencies >3%. Tble 8: The logistic regression nlysis for the reltion between the risk fctors nd ACS. Risk P OR vlue 95% CI Hypertension Smoking Dibetes rs T llele Smoking versus nonsmoking, hypertension versus nonhypertension, DM versus non-dm, rs T llele versus rs C llele. et l. [35] filed to show reltionship between rs nd MI in the Cost Ric Study. Firstly, this discrepncy my be due to rcil differences in two studies. Secondly, the reserch objects re different. Finlly, the difference of smple size lso my be nother possible reson. FADS2 is locted in chromosome 11 nd expressed in lmost ll humn tissues, especilly in the liver, hert, nd brin [36]. Some studies hve report the metbolic effects of polymorphisms in this gene or their effects on the risk of CAD [24]. But the locus rs of FADS2 is rrely reported. In 2011, our previous study showed tht this locus ws not ssocited with CAD [37], which is consistent with our present study. The reson my be tht lrge proportion of regultory SNPs, which ffect gene expression, re locted in the promoter regions [38]. At present, rs ner FADS1 is considered to be the most relevnt locus with ARA. GWAS in the In CHIANTI Study showed tht minor llele homozygotes rs (TT)

6 6 BioMed Reserch Interntionl hd lower plsm concentrtions of ARA compred to mjor llele homozygotes [25]. And study in Kore popultion confirmed tht rs T hd lower proportions of ARA in serum phospholipids nd reduced CAD risk [24]. Mny studies suggested the minor llele crriers including rs T my hve lower desturse ctivity [25, 37]. Therefore, bsed on bove results, possible cuslity link between lower desturse ctivity nd vsculr disese hs been suggested [39]. However, t present, the further reserch of gene function is still lcking. ELOVL2 is member of the mmmlin microsoml ELOVL ftty cid enzyme fmily, involved in the elongtion of very long-chin ftty cids including PUFAs required for vrious cellulr functions in mmmls [40]. A GWAS study found tht n ssocition of EPA with vrints in the FADS1 gene reched genome-wide significnce level, nd independent follow-up investigtion showed ssocitions of selected FADS1 vrint with erythrocyte membrne levels of EPA, ALA, nd DPA nd of n ELOVL2 vrint with DPA nd DHA [25]. These findings confirm n influence of FADS1 nd ELOVL2 onselectedn-3pufas.incontrst,wedonotfound the ssocition between rs of ELOVL2 gene nd ACS. Both llele nd genotype nlysis ll hve no sttisticl significnce, but the trns-phse gene-gene interction test reveled tht the ELOVL2 gene combined with FADS1 gene hd n effect on ACS. Above result implies tht the FADS1 gene- ELOVL2 gene interction my ffect PUFA concentrtions nd fford susceptibility to ACS. But the exct mechnisms for the interction re currently unknown. In conclusion, this cse-control study preliminry indictes tht vritions in FADS1 my ffect the risk of ACS nd provide genetic bsis of moleculr biology. We will continue to nlyze the gene functionl nd the serum levels of phospholipids ftty cid in ACS. Conflict of Interests All uthors hve no conflict of interests. Authors Contribution L. Qin nd Y.-F. Jing prticipted in the design nd conduct of the study, dt collection nd nlysis, dt interprettion, nd pper writing. Z.-K. Song nd H.-Y. Co prticipted in dt collection nd nlysis. All uthors red nd pproved thefinlpper.z.songcontributedtothiswork. Acknowledgments The uthors thnk the prticipnts for their support nd prticiption. This study ws sponsored by the Centrl Lb, the Second Division of the First hospitl, Jilin University, Jilin Province,Chin.TheygrtefullycknowledgeDr.LinXie who helps in designing the primers for the PCR processing. References [1] C. T. Ruff nd E. Brunwld, The evolving epidemiology of cute coronry syndromes, Nture Reviews Crdiology, vol. 8, no. 3, pp , [2] S. Yusuf, S. Reddy, S. Ôunpuu, nd S. 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