Introduction: At present, coronary heart disease (CHD) and myocardial infarction account for approximately two thirds of deaths from all cardiovascular diseases. It is known that morbidity and mortality from coronary heart disease is characterized by ethnographic heterogeneity, therefore, the study of genetic factors and their combinations for each individual population is of great scientific and practical interest.

Aim: To study the effect of the combination of PAI-1 and ApoE genotypes in Azerbaijanis with CHD on the prognosis of its patology.

Materials and methods: The study included 34 Azerbaijani patients of both sexes with CHD aged 39-65 years, in whom combinations of polymorphic markers of the ApoE and PAI-1 genes were identified. The study used genetic research methods (determination of the genotypes of the ApoE gene and the PAI-1 gene).  

Results: Combinations of genotypes 4G/4G and e4/e4, as well as genotypes 4G/4G and e2/e3, were studied. The choice of these genotypes is explained by the fact that the 4G/4G genotype was significantly more often present in patients with CHD compared with patients without CHD, and the genotypes of the ApoE gene were selected because of the reliably high values of atherogenic lipoproteins: low-density lipoprotein, total cholesterol – in the presence of the e4/e4 genotype and triglycerides – in patients with the e2/e3 genotype. 26 patients did not have a fatal outcome (FO), 8 patients died. In patients with CHD with FO, the combination of e4/e4 + 4G/4G genotypes was noted in 37.5% of cases, and in CHD without FO – in 19.2% of patients. The calculations performed did not show a significant difference in the results obtained. There was no statistically significant difference between patients with CHD with FO and without FO and in the presence of a combination of e2/e3 + 4G/4G genotypes, the frequency of which is 50.0% in the presence of FO and 53.8% without FO. Despite the presence of a prognostically unfavorable for CHD genotype 4G/4G of the PAI1 gene, as well as unfavorable in relation to the lipid profile of the e4/e4 and e2/e3 genotypes of the ApoE gene, the combination of these genotypes does not affect the prognosis of CHD in terms of the development of FO. The frequency of occurrence of a combination of e4/e4 + 4G/4G genotypes in patients with CHD and heart failure (HF) was found in 37.5% of individuals, which is statistically significantly higher than in patients with СHD without HF, for whom this combination of PAI-1 and ApoE genotypes was noted only in 7.69% of individuals. In patients with CHD, combined with arterial hypertension (AH), a statistically significant decrease in the incidence of the 4G/4G genotype, 18.2%, was found in comparison with its frequency in similar patients without AH (69.2%).

Conclusions: Thus, The study of the frequency of a combination of genotypes 4G/4G, e4/e4, and e2/e3, potentially dangerous for CHD, showed a statistically significant relationship between the combination of 4G/4G and e4/e4 genotypes with the presence of HF in patients with CHD.