Factor VII Arg/Gln(353) polymorphism determines factor VII coagulant activity in patients with myocardial infarction (MI) and control subjects in Belfast and in France but is not a strong indicator of MI risk in the ECTIM study

This paper describes the relationship of factor VII coagulant activity (FVIIc), FVII Arg/Gln(353) genotype and risk of myocardial infarction (MI) in the ECTIM (Etude Cas Temoin sur l'Infarctus du Myocarde) study, a multi-centre case-control study on MI. FVIIc was significantly higher in controls from all four centres: Belfast, Lille, Strasbourg and Toulouse, perhaps because elevated FVIIc may predispose to fatal rather than non-fatal MI. Major influences on FVIIc were FVII Arg/Gln, genotype, triglyceride and cholesterol levels. There was no significant effect of genotype on MI risk however there was a non-significant trend towards increased MI risk in FVII Arg(353) homozygotes. Confirming previous observations, FVIIc was highest in FVII Arg(353) homozygotes, intermediate in heterozygotes and lowest in FVII Gin(353) homozygotes (except Toulouse cases) these differences being highly statistically significant (except Strasbourg cases P = 0.1). In Belfast, consistent with previous findings, there was significant interaction between FVII Arg/Gln(353) genotype and triglyceride level in determining FVIIc, whilst this was absent in the French centres. In conclusion, FVII Arg/Gln(353) genotype strongly determines FVIIc although neither factor has a strong impact on MI risk in the ECTIM study.