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Thromb Haemost 2004; 91(04): 795-800
DOI: 10.1160/TH03-10-0619
Cell Signaling and Vessel Remodeling
Schattauer GmbH

Angiotensin-converting enzyme insertion/deletion polymorphism and risk of restenosis after directional coronary atherectomy followed by stent implantation

Umberto Canosi
1   Divisione di Cardiologia IRCCS Policlinico San Matteo, Pavia, Italy
,
Piera Angelica Merlini
2   II Divisione di Cardiologia, Ospedale Niguarda, Milan, Italy
,
Francesco Bernardi
3   Dipartimento di Biochimica e Biologia Molecolare, Università di Ferrara, Ferrara, Italy
,
Alessandra Repetto
1   Divisione di Cardiologia IRCCS Policlinico San Matteo, Pavia, Italy
,
Ezio Bramucci
1   Divisione di Cardiologia IRCCS Policlinico San Matteo, Pavia, Italy
,
Maurizio Ferrario
1   Divisione di Cardiologia IRCCS Policlinico San Matteo, Pavia, Italy
,
Luigi Angoli
1   Divisione di Cardiologia IRCCS Policlinico San Matteo, Pavia, Italy
,
Massimiliano Gnecchi
1   Divisione di Cardiologia IRCCS Policlinico San Matteo, Pavia, Italy
,
Paolo Ferraresi
3   Dipartimento di Biochimica e Biologia Molecolare, Università di Ferrara, Ferrara, Italy
,
Giovanna Marchetti
3   Dipartimento di Biochimica e Biologia Molecolare, Università di Ferrara, Ferrara, Italy
,
Luigi Tavazzi
1   Divisione di Cardiologia IRCCS Policlinico San Matteo, Pavia, Italy
,
Diego Ardissino
4   Divisione di Cardiologia Ospedale Maggiore, Parma, Italy
› Author Affiliations
Further Information

Publication History

Received 07 October 2003

Accepted after resubmission 29 February 2003

Publication Date:
06 December 2017 (online)

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Summary

The D allele of the insertion/deletion (I/D) polymorphism of the angiotensin I-converting enzyme (ACE) gene is associated with higher plasma and tissue ACE levels, which enhance the stimulus for neo-intimal hyperplasia. Plaque debulking before stenting reduces the plaque-related determinants of in-stent restenosis and provides an ideal clinical model for studying neointimal hyperplasia. We prospectively studied 113 consecutive patients undergoing elective DCA followed by stent implantation. The presence of I/D in ACE genome DNA was analysed by means of polymerase chain reaction. Follow-up coronary angiography was performed 6-12 months after DCA, and all of the angiograms were quantitatively analysed. The baseline clinical and angiographic characteristics of the patients with a D/D (33%), I/D (52%) and I/I (15%) genotype were well balanced. There were no significant differences in minimal lumen diameter before and after the procedure or at follow-up, and no significant differences in acute gain, late loss or the loss index. Our results indicate that ACE I/D polymorphism does not influence the risk of developing angiographic restenosis in patients undergoing DCA followed by stent implantation.

Keywords

ACE-gene polymorphism - restenosis - stent - directional coronary atherectomy
 

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