Angiotensin-converting enzyme insertion/deletion polymorphism and risk of restenosis after directional coronary atherectomy followed by stent implantation.
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.
Canosi
Umberto
U
Divisione di Cardiologia IRCCS Policlinico San Matteo, Piazza Golgi 2, 27100 Pavia, Italy. laboratorio.emodinamica@smatteo.pv.it
Angelica Merlini
Piera
P
Bernardi
Francesco
F
Repetto
Alessandra
A
Bramucci
Ezio
E
Ferrario
Maurizio
M
Angoli
Luigi
L
Gnecchi
Massimiliano
M
Ferraresi
Paolo
P
Marchetti
Giovanna
G
Tavazzi
Luigi
L
Ardissino
Diego
D
D017225:Atherectomy, Coronary / Q000009:adverse effects; D017023:Coronary Angiography; D023903:Coronary Restenosis / Q000209:etiology / Q000235:genetics*; D005260:Female; D005500:Follow-Up Studies; D020022:Genetic Predisposition to Disease; D005838:Genotype; D006801:Humans; D008297:Male; D008875:Middle Aged; D007703:Peptidyl-Dipeptidase A / Q000235:genetics* / Q000502:physiology; D011110:Polymorphism, Genetic; D012306:Risk; D017384:Sequence Deletion; D015607:Stents / Q000009:adverse effects*
D007703:Peptidyl-Dipeptidase A