Affiliation:
1. From INSERM CJF 95-05, Institut Pasteur de Lille (C.A., F.R., N.H., P.A.); University and CHRU de Lille (C.B., J.-C.B., J.-M.L., M.H., F.R., E.P.M., P.A., M.E.B.); University and CHRU de Caen (G.G.); and University and CHRU de Nancy (N.D.), France.
Abstract
Background
Although intracoronary stent implantation significantly reduces restenosis compared with balloon angioplasty, a minority of patients still develop restenosis predominantly due to neointimal hyperplasia. Experimental studies suggest that the renin-angiotensin system is involved in neointimal hyperplasia after arterial injury. In humans, the plasma and cellular levels of ACE are associated with an
I/D
genetic polymorphism in the
ACE
gene,
DD
patients having higher levels.
Methods and Results
We investigated a possible relation between the
ACE I/D
polymorphism and restenosis in 146 patients who underwent successful implantation of a Palmaz-Schatz stent and had 6-month follow-up angiography. The minimal lumen diameter (MLD) before and after the procedure did not differ significantly among the three groups of genotypes (
DD
,
ID
, and
II
). At follow-up, MLD had a significant inverse relationship to the number of
D
alleles present (
DD
, 1.65±0.71 mm;
ID
, 1.84±0.60 mm;
II
, 2.05±0.61 mm;
P
<.007). Late luminal loss during the follow-up period was significantly related to the number of
D
alleles (
DD
, 0.89±0.61 mm;
ID
, 0.60±0.52 mm;
II
, 0.40±0.53 mm;
P
<.0001). The relative risk of restenosis (defined as a >50% diameter stenosis at follow-up) approximated by the adjusted odds ratio was 2.00 per number of
D
alleles (95% confidence interval, 1.03 to 3.88,
P
<.04).
Conclusions
The
ACE I/D
polymorphism influences the level of late luminal loss after coronary stent implantation. These results suggest that the renin-angiotensin system may be implicated in the pathogenesis of restenosis after coronary stenting.
Publisher
Ovid Technologies (Wolters Kluwer Health)
Subject
Physiology (medical),Cardiology and Cardiovascular Medicine
Cited by
94 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献