الفهرس 
Chapter (I): coronary artery diseaseOnly 14 pages are availabe for public view
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Abstract
CAD is the most common type of heart disease. It is the leading
cause of cardiovascular mortality worldwide, with more than 4.5 million
deaths occurring in the developing world. Despite a decline in developed
countries, both CAD mortality and the prevalence of CAD risk factors
continue to rise rapidly in developing countries.
There are many risk factors that can lead to CAD: high blood
pressure, smoking, diabetes, lack of exercise, obesity, high blood
cholesterol, poor diet, depression, and excessive alcohol intake.
More than 250 genes play critical roles in CAD predisposition that
are involved in increasing or decreasing risks of CAD.
The most critical manifestations of the CAD are MI and angina,
with the ultimate development of thrombosis of coronary arteries and
rupture of the plaques.
Therefore, identification of the residual risk for cardiovascular
disease is essential for more effective management and prevention.
Platelets are essential for primary hemostasis and repair of the
endothelium, but they also play a key role in the pathogenesis of
atherosclerosis and arterial thrombosis.
Increased MPV has been noted in subjects with cardiovascular risk
factors, such as smoking, diabetes, obesity, HTN, and hyperlipidemia. In
subjects with established cardiovascular disease, elevated MPV may be a
marker for adverse cardiovascular events.
Receptors of the membrane GP on the platelets are involved in the
activation, aggregation, and adhesion of platelets, the serialized
occurrences that culminate in thrombus formation and development of
ACS.
Additionally genetic polymorphisms in HPAs have been
recognized to be associated with susceptibility to CAD.
Several studies have indicated an association between multiple
genetic polymorphisms harbored by the genes coding the platelet GPs
with dysregulated functions of the platelets, such as promoted platelet
adhesion and aggregation, and therefore increase the risk of CAD.
Severity of coronary atherosclerosis is closely associated with
cardiovascular prognosis in patients with ACS.
Gensini score is a widely used means of quantifying angiographic
atherosclerosis, where a zero score indicates absence of atherosclerotic
disease, The Gensini score accounts for the degree of artery narrowing as
well as locations of narrowing.
The aim of this study is to evaluate the association of human
platelet alloantigen-3 gene polymorphisms HPA-3 T2622G (rs5911) and
the risk of CAD in Egyptian patients. This study was conducted on 95
patients referred to hospitals of Menoufia University`s Cath lab for
coronary angiography from August 2022 to March 2023.
The main results of the study revealed that, patients in both groups
were age and sex matched, the mean age of patients in CAD group was
58.49±9.17 years and 55.96±11.41 years in control group. There were 37
males and 12 females in CAD group while there was 27 males and 19
females in control group (p>0.05). There was significant higher rate of
smokers, diabetics, patients with positive family history and patients with
higher LDL levels in CAD group compared to control group (p<0.001,
p=0.04, p=0.04, p= 0.013) respectively. There was a significant decrease
in HDL level in CAD group compared to control group (p=0.029). No
statistically significant difference was found between the two groups
regarding HTN (p>0.05). The mean EF in CAD group was 48.43±7.98% and 59.41±6.12 % in control group. There was significant decline in EF
in CAD group compared to control group (p<0.001).