title: Angiotensin-converting enzyme insertion/deletion polymorphism and risk of restenosis after directional coronary atherectomy followed by stent implantation.
abstract: 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.
authors.affiliation: Divisione di Cardiologia IRCCS Policlinico San Matteo, Piazza Golgi 2, 27100 Pavia, Italy. laboratorio.emodinamica@smatteo.pv.it
authors.forename: Umberto
authors.initials: U
authors.lastname: Canosi
authors.forename: Piera
authors.initials: P
authors.lastname: Angelica Merlini
authors.forename: Francesco
authors.initials: F
authors.lastname: Bernardi
authors.forename: Alessandra
authors.initials: A
authors.lastname: Repetto
authors.forename: Ezio
authors.initials: E
authors.lastname: Bramucci
authors.forename: Maurizio
authors.initials: M
authors.lastname: Ferrario
authors.forename: Luigi
authors.initials: L
authors.lastname: Angoli
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Gnecchi
authors.forename: Paolo
authors.initials: P
authors.lastname: Ferraresi
authors.forename: Giovanna
authors.initials: G
authors.lastname: Marchetti
authors.forename: Luigi
authors.initials: L
authors.lastname: Tavazzi
authors.forename: Diego
authors.initials: D
authors.lastname: Ardissino
mesh_terms: 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*
chemical_list: D007703:Peptidyl-Dipeptidase A