Association of a genetic variant of endothelial nitric oxide synthase with the 1 year clinical outcome after coronary stent placement.
OBJECTIVE
Endothelial nitric oxide synthase (eNOS) catalyzes the formation of nitric oxide which has vasodilatory, antithrombotic, antiinflammatory and antiproliferative properties. The TT genotype of the single nucleotide polymorphism 894 G/T, located in exon 7 of the eNOS gene, was found to be associated with coronary spasm, coronary artery disease (CAD) and myocardial infarction (MI). We investigated the possibility that the 894 TT genotype has an unfavorable impact on the angiographic and clinical outcome after the placement of stents in coronary arteries.


RESULTS
Our study included 1850 patients with CAD who were treated with stent implantation. Major adverse clinical events, including death, MI, and target vessel revascularization, were recorded for 1 year after the intervention. Patients with genotype 894 TT had an increase in the risk of death or MI (hazard ratio 2.14, 95% confidence interval (CI) 1.23-3.72; p=0.007), if compared with G allele carriers. TT patients showed no significant increase in the risk for angiographic restenosis (odds ratio (OR) 1.11, 95% CI 0.78-1.56; p=0.56) and target vessel revascularization (OR 1.21, 95% CI 0.82-1.78; p=0.34).


CONCLUSIONS
In comparison with eNOS 894 G allele carriers, patients of the TT genotype were at an increased risk of death or MI within 1 year after coronary artery stenting.
Deutsches Herzzentrum München, Technische Universität München, Lazarettstrasse 36, 80636 München, Germany.
Olga
O
Gorchakova
Werner
W
Koch
Nicolas
N
von Beckerath
Julinda
J
Mehilli
Albert
A
Schömig
Adnan
A
Kastrati
D000208:Acute Disease; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000201:enzymology* / Q000628:therapy; D023921:Coronary Stenosis / Q000209:etiology; D003328:Coronary Thrombosis / Q000209:etiology; D003329:Coronary Vasospasm / Q000201:enzymology*; D005260:Female; D005838:Genotype; D006720:Homozygote; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000201:enzymology*; D019001:Nitric Oxide Synthase / Q000235:genetics*; D052250:Nitric Oxide Synthase Type III; D012307:Risk Factors; D015607:Stents
C496314:NOS3 protein, human; D019001:Nitric Oxide Synthase; D052250:Nitric Oxide Synthase Type III