Vitamin K epoxide reductase complex subunit 1 gene polymorphism is associated with atherothrombotic complication after drug-eluting stent implantation: 2-Center prospective cohort study.
BACKGROUND
Single nucleotide polymorphisms of vitamin K epoxide reductase complex subunit 1 (VKORC1) was reported to have association with arterial vascular disease. We investigated whether single nucleotide polymorphism of VKORC1 +2255 is associated with clinical outcomes among patients who underwent drug-eluting stent (DES) implantation.


METHODS
We prospectively collected genomic DNA in patients who underwent DES deployment from September 2003 to December 2006 and compared clinical outcomes according to their VKORC1 genotype at the locus + 2255 (rs 2359612). The primary end point was composite of atherothrombotic events (cardiac death, myocardial infarction, and nonhemorrhagic stroke).


RESULTS
Mean follow-up duration was 631 +/- 251 days. Genotyping was completed in 764 cases (TT genotype [n = 640, 83.8%] vs non-TT [CC or CT] genotype [n = 124, 16.2%]). Non-TT group showed more composite events than TT group (7.3% vs 3.0%, P = .032). In the Cox regression analysis, non-TT genotype of VKORC gene was a significant predictor of atherothrombotic events (hazard ratio 2.56, 95% confidence interval 1.14-5.78). In the event-free survival analysis, non-TT group also showed significantly poorer cardiovascular events-free survival rate than TT group (P = .02).


CONCLUSIONS
VKORC1 genotype is associated with cardiovascular events in patients with DES implantation, suggesting the role of coagulation system.
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea.
Jung-Won
JW
Suh
Sang-Hong
SH
Baek
Jin-Shik
JS
Park
Hyun-Jae
HJ
Kang
In-Ho
IH
Chae
Dong-Ju
DJ
Choi
Hun-Jun
HJ
Park
Pum-Joon
PJ
Kim
Ki-Bae
KB
Seung
Hyo-Soo
HS
Kim
D050197:Atherosclerosis / Q000150:complications / Q000201:enzymology / Q000235:genetics*; D003327:Coronary Disease / Q000601:surgery; D004247:DNA / Q000235:genetics*; D054855:Drug-Eluting Stents; D005260:Female; D005500:Follow-Up Studies; D005838:Genotype; D006801:Humans; D007723:Korea / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D006899:Mixed Function Oxygenases / Q000097:blood / Q000235:genetics*; D009204:Myocardial Revascularization / Q000009:adverse effects* / Q000295:instrumentation; D016133:Polymerase Chain Reaction; D011110:Polymorphism, Genetic; D011183:Postoperative Complications; D011446:Prospective Studies; D015996:Survival Rate; D013927:Thrombosis / Q000201:enzymology / Q000209:etiology* / Q000401:mortality; D013997:Time Factors; D064417:Vitamin K Epoxide Reductases
D004247:DNA; D006899:Mixed Function Oxygenases; C578523:VKORC1 protein, human; D064417:Vitamin K Epoxide Reductases