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Gene Variant Linked to Worse Outcomes in Pneumonia

Last Updated: April 28, 2009.

Patients hospitalized with severe pneumonia have a higher risk of death and spend a longer time on mechanical ventilation if they have a variant of the plasminogen activator inhibitor-1 (PAI-1) gene, according to a study in the May issue of Anesthesiology.

TUESDAY, April 28 (HealthDay News) -- Patients hospitalized with severe pneumonia have a higher risk of death and spend a longer time on mechanical ventilation if they have a variant of the plasminogen activator inhibitor-1 (PAI-1) gene, according to a study in the May issue of Anesthesiology.

Anil Sapru, M.D., from the University of California in San Francisco, and colleagues analyzed the distribution of the 4G allele of the PAI-1 gene, which is associated with higher levels of the PAI-1 protein and higher mortality and hospitalizations, in 111 patients in the intensive care unit with severe pneumonia.

The researchers found that 23 percent of patients were homozygous for the 4G allele (4G/4G), 53 percent were heterozygous for the 4G allele (4G/5G), 23 percent were homozygous for the 5G allele (5G/5G), 29 percent died before discharge, and 94 percent received mechanical ventilation. Compared with patients homozygous for the 5G allele, patients with at least one 4G allele had significantly higher mortality (35 versus 8 percent) and significantly fewer ventilation-free days (median 4 versus 13 days).

"The 4G allele of the 4G/5G polymorphism in the PAI-1 gene is associated with fewer ventilator-free days and increased mortality in hospitalized patients with severe pneumonia," Sapru and colleagues conclude. "These findings suggest that PAI-1 may have a role in pathogenesis and that the 4G/5G polymorphism may be an important biomarker of risk in patients with severe pneumonia."

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