Vitamin D receptor: a new risk marker for clinical restenosis after percutaneous coronary intervention.
OBJECTIVE
Restenosis is the main drawback of percutaneous coronary intervention (PCI). Inherited factors may explain part of the risk of restenosis. Recently, the vitamin D receptor (VDR) has been shown to be involved not only in bone metabolism but also in modulating immune responses and cell proliferation. Since the inflammatory response is implicated in restenosis, VDR-gene variants could therefore contribute to the risk of restenosis.


RESULTS
Systematic genotyping for 15 haplotype tagging single-nucleotide polymorphisms (SNPs) of the VDR gene was performed with the high throughput TaqMan allelic discrimination assays in the Genetic Determinants of Restenosis (GENDER) population. A haplotype-based survival analysis revealed an association of haplotypes in blocks 2, 3 and 4 of the VDR-gene with the risk of clinical restenosis (p-values 0.01, 0.04 and 0.02 respectively). After adjustment for clinical risk factors for restenosis, the individual effect of the block 2 AA haplotype (p = 0.011) persisted.


CONCLUSIONS
The present study indicates that VDR plays a role in restenosis after PCI. Therefore, VDR genotype may be used as risk marker for restenosis and may contribute to individual patient screening prior to PCI in clinical practice.
Monraats
Pascalle S
PS
Leiden University Medical Center, Department of Cardiology, C5-P, PO Box 9600, 2300 RC Leiden, The Netherlands.
Fang
Yue
Y
Pons
Douwe
D
Pires
Nuno M M
NM
Pols
Huibert A P
HA
Zwinderman
Aeilko H
AH
de Maat
Moniek P M
MP
Doevendans
Pieter Af
PA
DeWinter
Robbert J
RJ
Tio
René A
RA
Waltenberger
Johannes
J
Frants
Rune R
RR
Quax
Paul H A
PH
van der Laarse
Arnoud
A
van der Wall
Ernst E
EE
Uitterlinden
André G
AG
Jukema
J Wouter
JW
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects*; D015415:Biomarkers; D023903:Coronary Restenosis / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D005838:Genotype; D006239:Haplotypes; D006801:Humans; D008297:Male; D008875:Middle Aged; D020641:Polymorphism, Single Nucleotide; D018167:Receptors, Calcitriol / Q000235:genetics*; D012307:Risk Factors; D016019:Survival Analysis
D015415:Biomarkers; D018167:Receptors, Calcitriol