Association study of the I/D polymorphism and plasma angiotensin-converting enzyme (ACE) as risk factors for stent restenosis
| Autor: | Antonello Vado, Mauro Feola, Corrado Vassanelli, Flavio Ribichini, Eugenio Uslenghi, Giuseppe Matullo, Sonia Carturan, Terenzio Camilla, Simonetta Guarrera, Valeria Ferrero, Alberto Piazza |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2004 |
| Předmět: |
Male
medicine.medical_specialty Genotype Peptidyl-Dipeptidase A Lower risk angioplasty angiotensin-converting enzyme (ACE) polymorphism restenosis stent Gastroenterology Coronary Restenosis Restenosis Risk Factors Internal medicine Blood plasma medicine Humans Myocardial infarction Angioplasty Balloon Coronary Aged Analysis of Variance Polymorphism Genetic biology business.industry Coronary Stenosis Angiotensin-converting enzyme General Medicine Odds ratio Middle Aged medicine.disease Coronary Vessels Confidence interval Endocrinology Sample Size Multivariate Analysis biology.protein Female Stents business |
| Popis: | The ID (insertion/deletion) polymorphism of the ACE (angiotensin-converting enzyme) gene controls plasma ACE levels. Both have been correlated with ISR (in-stent restenosis) in preliminary analyses, but not confirmed in larger studies. In the present study, baseline and 6-month quantitative coronary analysis were performed in 897 patients who had stent implantation and the ID polymorphism genotyped. Plasma ACE levels were measured in 848 patients (95 %). Restenosis rates among genotypes were 31.2 % DD, 25.5 % ID and 28.8 % II (not significant). Plasma ACE levels were significantly higher in restenotic patients compared with patients without restenosis (30.7 + 18.6 units/l compared with 22.8 + 12.8 units/l; P = 0.0001) and a strong independent predictor of ISR [OR (odds ratio) = 3.70; 95 % CI (confidence interval), 2.40–5.71; P < 0.0001], except in diabetics. In the subgroup of diabetics and patients with AMI (acute myocardial infarction), the DD genotypes actually had a lower risk of ISR than the II genotypes (diabetics, OR = 0.16; 95 % CI, 0.04–0.69; P = 0.014; and patients with AMI, OR = 0.21; 95 % CI, 0.061–0.749; P = 0.016). After exclusion of diabetics and patients with AMI, ISR rates for genotypes in 632 patients were 31.7 % DD, 24.3 % ID and 17.6 % II (P = 0.02; DD compared with non-DD OR = 1.57; 95 % CI, 1.09–2.25). The association between the D allele and ISR observed in selected populations does not hold with a larger sample size. Other than sample size, clinical variables can modulate the association between ID polymorphism and ISR. Plasma ACE level is a risk factor for ISR, independently of the ID genotype. |
| Databáze: | OpenAIRE |
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