Previous studies have shown that the rs1044925 single nucleotide polymorphism (SNP) of ACAT-1 gene is associated with the risk of coronary heart disease and ischemic stroke, and both are correlated to the level of blood lipid.

To observe the relationship between rs1044925 SNP of ACAT-1 gene and acute coronary syndrome (ACS) , and the relationship between rs1044925 SNP and the change of serum lipids level in response to atorvastatin treatment in patients with ACS.

111 patients diagnosed with ACS and treated with percutaneous coronary intervention (PCI) in the Department of Geriatric Cardiovascular, People's Hospital of Guangxi Zhuang Autonomous from January 2016 to January 2018 were selected in ACS group (67 males and 44 females) . All patients were treated with atorvastatin 20 mg per night, Clopidogrel 75 mg, once a day (or tegranolol 90 mg, twice a day) , and Aspirin 100 mg, once a day. Atorvastatin 20 mg/night was routinely used after PCI. The control group consisted of 338 healthy people in the same time period (170 males and 168 females) . ACAT-1 rs1044925 SNP was genotyped by polymerase chain reaction and restriction fragment length polymorphism (PCR-RFLP) . The baseline blood lipid levels of ACS group and control group were detected. The blood lipid parameters of the ACS group were measured after treatment of atorvastatin for one year averagely.

There was no statistical difference in serum TC between the ACS group and the control group (P>0.05) , but there were statistical differences in the levels of TG, HDL-C, LDL-C, ApoAI, and ApoB (P<0.05) between the two gruops. There was no statistical difference in the distribution of ACAT-1 rs1044925 SNP genotype and allele frequency between the ACS group and the control group (P>0.05) . There was no statistical difference in the levels of TC, TG, HDL-C, LDL-C, ApoAI and ApoB among each genotype group of ACAT-1 rs1044925 SNP in the control group (P>0.05) . After atorstatin treatment, the serum TC, LDL-C, ApoAI, ApoB and lipoprotein (Lp) (α) levels in ACS patients were statistically different from baseline levels (P<0.05) . There was no statistical difference in the levels of TC, TG, HDL-C, LDL-C, ApoAI, and ApoB at baseline among the genotypes from starting point and one year later in the ACS group (P>0.05) . There was no statistical difference in the baseline of Lp (α) level among genotypes (P>0.05) in ACS patients, but after 1 year of treatment, the Lp (α) level of each genotype was statistically different (P<0.05) . Comparing baseline levels with the levels of TC, LDL-C, ApoAI, ApoB, Lp (α) after treatment in patients with AA genotype and comparing baseline levels with the levels of TC, LDL-C, ApoB levels in patients with AC/CC genotype after treatment, the differences were statistically significant (P<0.05) . Comparing the decrease in the levels of TC, LDL-C, ApoB with the increase of level in ApoAI after atorvastatin treatment between different genotypes, there was no statistical difference (P>0.05) . There was statistical difference among the decrease in the levels of Lp (α) after atorvastatin treatment among different genotypes (P<0.05) .

This study demonstrates that the ACAT-1 rs1044925 SNP is not significantly associated with ACS. However, ACS patients with rs1044925 SNP AA genotype have better decreasing effect in Lp (α) level than patients with AC/CC genotype after atorvastatin treatment.