Estrogen receptor-alpha polymorphisms and angiographic outcome after coronary artery stenting.
OBJECTIVE
Because of the receptor-mediated antiproliferative effects of estradiol on vascular smooth muscle cells, our study aimed at identifying a role of PvuII and XbaI polymorphisms of the alpha-estrogen receptor (alphaER) gene in the occurrence of restenosis after coronary stent implantation (in-stent restenosis [ISR]).


RESULTS
In 858 patients (148 women), 955 lesions were treated with stent implantation, and the PvuII C/T and XbaI G/A polymorphisms of the alphaER gene were determined. Quantitative angiography was performed before and after stenting and at 6-month follow-up. The allelic frequencies were similar between sexes (C/T allele, 0.43/0.57 and 0.44/0.56; P=0.9; G/A allele, 0.35/0.65 and 0.38/0.62; P=0.8; in women and men, respectively). A significantly higher ISR rate in women than in men homozygous for the T-allele of the PvuII polymorphism (42.6% versus 26.9%, P=0.03) or the G-allele of the XbaI polymorphism (41.2% versus 19.4%, P=0.04) was observed. At multivariate analysis, T/T genotype was the only independent predictor of ISR in women but not in men (odds ratio, 1.5; 95% CI, 1.0 to 2.1; P=0.03). XbaI polymorphism was no longer associated with ISR in both sexes.


CONCLUSIONS
Women homozygous for the T-allele of the PvuII polymorphism of the alphaER gene treated with coronary stent implantation have a higher risk of ISR than men.
Ferrero
Valeria
V
Division of Cardiology, Universita del Piemonte Orientale, Ospedale Maggiore della Carita, Novara, Italy.
Ribichini
Flavio
F
Matullo
Giuseppe
G
Guarrera
Simonetta
S
Carturan
Sonia
S
Vado
Antonello
A
Vassanelli
Corrado
C
Piazza
Alberto
A
Uslenghi
Eugenio
E
Wijns
William
W
D017023:Coronary Angiography / Q000379:methods / Q000706:statistics & numerical data; D023903:Coronary Restenosis / Q000150:complications / Q000235:genetics* / Q000601:surgery; D003331:Coronary Vessels / Q000473:pathology / Q000601:surgery; D047628:Estrogen Receptor alpha; D005260:Female; D005787:Gene Frequency; D005838:Genotype; D006801:Humans; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D011110:Polymorphism, Genetic / Q000235:genetics* / Q000502:physiology; D011237:Predictive Value of Tests; D019919:Prosthesis Implantation; D011960:Receptors, Estrogen / Q000145:classification / Q000235:genetics* / Q000502:physiology; D017678:Sex Distribution; D012737:Sex Factors; D015607:Stents; D016896:Treatment Outcome
D047628:Estrogen Receptor alpha; D011960:Receptors, Estrogen