Role of Kozak sequence polymorphism of platelet glycoprotein Ibalpha as a risk factor for coronary artery disease and catheter interventions.
OBJECTIVE
We sought to determine the role of the -5T/C polymorphism of the platelet glycoprotein (GP) Ibalpha as a potential risk factor for coronary artery disease (CAD) and adverse events complicating a coronary catheter intervention.


BACKGROUND
The platelet GP Ib-IX-V receptor complex plays a crucial role in arterial thrombus formation. The -5T/C polymorphism of GP Ibalpha is associated with increased receptor density.


METHODS
We genotyped 1,000 patients with angiographically confirmed CAD, as well as 1,000 age- and gender-matched control subjects, for this polymorphism by polymerase chain reaction/restriction fragment length polymorphism. Among the patients with CAD, 269 underwent percutaneous transluminal coronary angioplasty (PTCA), 103 underwent directional coronary atherectomy and 278 underwent stenting. This intervention group was followed for a 30-day composite end point of target vessel revascularization, myocardial infarction or death.


RESULTS
Carriers of the -5C allele were significantly over-represented in the group of patients developing acute coronary syndromes (relative risk [RR] 1.43, 95% confidence interval [CI] 1.05 to 1.95, p = 0.02). The -5C allele furthermore predicted an increased risk for developing complications after PTCA (RR 3.75, 95% CI 1.15 to 12.27, p = 0.029).


CONCLUSIONS
The -5C allele of the GP Ibalpha Kozak polymorphism may represent a risk factor in clinical conditions in which thrombosis plays an important role, such as in acute coronary syndromes and in complications after PTCA.
Meisel
C
C
Institute of Clinical Pharmacology, Berlin, Germany.
Afshar-Kharghan
V
V
Cascorbi
I
I
Laule
M
M
Stangl
V
V
Felix
S B
SB
Baumann
G
G
López
J A
JA
Roots
I
I
Stangl
K
K
D000368:Aged; D000483:Alleles; D015906:Angioplasty, Balloon, Coronary; D017225:Atherectomy, Coronary; D017023:Coronary Angiography; D003328:Coronary Thrombosis / Q000235:genetics* / Q000628:therapy*; D005260:Female; D005838:Genotype; D006801:Humans; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization; D019038:Platelet Glycoprotein GPIb-IX Complex / Q000235:genetics*; D011110:Polymorphism, Genetic; D012307:Risk Factors; D015607:Stents
D019038:Platelet Glycoprotein GPIb-IX Complex