Association of the T-786C polymorphism of the nitric oxide synthase 3 gene with acute coronary syndrome or premature coronary artery disease: A systematic review and meta-analysis.

A systematic review and a study level meta-analysis was conducted to assess the association between the T-786C polymorphism of the nitric oxide synthase 3 (NOS3) gene with acute coronary syndrome (ACS) or premature coronary artery disease (PCAD). Online databases of PubMed, EMBASE, MEDLINE, Scopus, Cochrane library and Web of Science were systematically searched, yielding 23 different studies (from 22 articles, involving 17,324 subjects), which were included for quantitative synthesis. Study level odds ratios (ORs) and their 95% confidence intervals (CI) were pooled using random effects, employing a Z test. Pooled results suggested a significant association between T-786C polymorphism and ACS or PCAD through dominant and allelic genetic model comparisons (OR, 1.26, 95% CI, 1.09-1.45, p = 0.001 and OR, 1.26, 95% CI, 1.11-1.43, p = 0.0002 respectively). Leave-one-out sensitivity analysis, in addition to the results for the myocardial infarction endpoint, attested to the robustness of the obtained results. Large, prospective investigations are, however, warranted to confirm the presented findings.