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

Umberto Canosi; Piera Angelica Merlini; Francesco Bernardi; Alessandra Repetto; Ezio Bramucci; Maurizio Ferrario; Luigi Angoli; Massimiliano Gnecchi; Paolo Ferraresi; Giovanna Marchetti; Luigi Tavazzi; Diego Ardissino

doi:10.1160/TH03-10-0619

Thrombosis and Haemostasis, Inhaltsverzeichnis

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

¹Divisione di Cardiologia IRCCS Policlinico San Matteo, Pavia, Italy

,

Piera Angelica Merlini

²II Divisione di Cardiologia, Ospedale Niguarda, Milan, Italy

,

Francesco Bernardi

³Dipartimento di Biochimica e Biologia Molecolare, Università di Ferrara, Ferrara, Italy

,

Alessandra Repetto

¹Divisione di Cardiologia IRCCS Policlinico San Matteo, Pavia, Italy

,

Ezio Bramucci

¹Divisione di Cardiologia IRCCS Policlinico San Matteo, Pavia, Italy

,

Maurizio Ferrario

¹Divisione di Cardiologia IRCCS Policlinico San Matteo, Pavia, Italy

,

Luigi Angoli

¹Divisione di Cardiologia IRCCS Policlinico San Matteo, Pavia, Italy

,

Massimiliano Gnecchi

¹Divisione di Cardiologia IRCCS Policlinico San Matteo, Pavia, Italy

,

Paolo Ferraresi

³Dipartimento di Biochimica e Biologia Molecolare, Università di Ferrara, Ferrara, Italy

,

Giovanna Marchetti

³Dipartimento di Biochimica e Biologia Molecolare, Università di Ferrara, Ferrara, Italy

,

Luigi Tavazzi

¹Divisione di Cardiologia IRCCS Policlinico San Matteo, Pavia, Italy

,

Diego Ardissino

⁴Divisione di Cardiologia Ospedale Maggiore, Parma, Italy

› Institutsangaben

Abstract

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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