Relation of polymorphisms in five genes to long-term aortocoronary saphenous vein graft patency.
Saphenous veins grafts (SVGs) continue to be used as conduits for coronary bypass surgery in nearly 350,000 patients annually in the United States. A possible genetic contribution to SVG longevity has not been well studied. We analyzed 168 single nucleotide polymorphisms from 150 candidate genes in 155 patients (2.1 SVGs/patient) followed for 10 +/- 4 years who underwent coronary angiography for clinical indications. Age at coronary bypass was 54 +/- 8 years, 61% were men, and 39% had diabetes mellitus. At the time of study entry, 76% were on statins. SVG patency (<70% diameter stenosis, no intervention), the primary study end point, was 60% at 5 years and 19% at 10 years. After adjustment for other factors associated with SVG patency (male gender, p = 0.007; low low-density lipoprotein, p = 0.016), 7 polymorphisms in 5 genes were associated with SVG patency (p <0.01). In conclusion, these data represent an initial step toward the use of a personalized genetic approach to coronary revascularization.
Ellis
Stephen G
SG
Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio, USA. elliss@ccf.org
Chen
Michael S
MS
Jia
Gang
G
Luke
May
M
Cassano
June
J
Lytle
Bruce
B
D000367:Age Factors; D000924:Anticholesteremic Agents / Q000627:therapeutic use; D016022:Case-Control Studies; D008078:Cholesterol, LDL / Q000097:blood; D003179:Complement C3b / Q000235:genetics; D050716:Complement C4b-Binding Protein / Q000235:genetics; D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D023921:Coronary Stenosis / Q000601:surgery; D048909:Diabetes Complications; D005260:Female; D005500:Follow-Up Studies; D006682:HLA-DP Antigens / Q000235:genetics; D059868:HLA-DP beta-Chains; D015395:Histocompatibility Antigens Class I / Q000235:genetics; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D020641:Polymorphism, Single Nucleotide / Q000235:genetics*; D012501:Saphenous Vein / Q000637:transplantation*; D012737:Sex Factors; D040301:Vascular Endothelial Growth Factor Receptor-2 / Q000235:genetics; D014654:Vascular Patency / Q000235:genetics*; D019096:Vitronectin / Q000235:genetics
D000924:Anticholesteremic Agents; D008078:Cholesterol, LDL; D050716:Complement C4b-Binding Protein; D006682:HLA-DP Antigens; D059868:HLA-DP beta-Chains; C071170:HLA-DPB1 antigen; D015395:Histocompatibility Antigens Class I; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; C099187:MHC class I-related chain A; D019096:Vitronectin; D003179:Complement C3b; D040301:Vascular Endothelial Growth Factor Receptor-2