title: Is evaluation of complex polymorphism helpful in the assessment of prognosis after percutaneous coronary intervention. A prospective study.
abstract: BACKGROUND
  Coronary artery disease (CAD) is a complex disorder accounting for the majority of cardiovascular deaths and morbidity. It is believed that genetic factors explain part of the excessive risk of major adverse cardiac events (MACE) after percutaneous coronary intervention (PCI).
  
  
  OBJECTIVE
  To evaluate the influence on long-term prognosis of some genetic polymorphisms affecting renin-angiotensin system, inflammatory response, beta-2 adrenergic receptor, nitric oxide and platelets activity in patients with stable CAD undergoing routine PCI.
  
  
  METHODS
  The study population consisted of 110 consecutive male patients with stable angina undergoing elective, single-vessel PCI. Genotyping was performed by polymerase chain reaction and restriction fragment length polymorphism-based techniques. Follow-up data were obtained by postal questionnaires regarding survival, myocardial infarction and revascularisation procedures. The control group consisted of 78 healthy males.
  
  
  RESULTS
  Compared to controls, the distribution of polymorphisms among patients differed with regard to interleukin-1 receptor antagonist and CD14 variants. Patients who had PCI during follow-up in comparison with the remaining patients had a similar genetic profile, but higher triglycerides (1.9 vs 1.5 mmol/L, p = 0.01) and atherogenic index (3.8% vs 3.1%, p = 0.03) and lower percentage of HDL (21.8% vs 25.0%, p = 0.02). Among subjects with any revascularisation procedures, a similar clinical profile was observed. However, they differed from those without any procedures regarding the distribution of angiotensinogen M235T variants (MM%/TM%/TT%) 28%/64%/8% vs 19%/50%/31%, p = 0.048. Stratification for myocardial infarction showed association with selectin E variants (AA%/AC%/CC%) 57.1%/28.6%/14.3% vs 78.8%/21.2%/0%, p = 0.055 and higher triglycerides (2.11 vs 1.57 mmol/L, p = 0.055).
  
  
  CONCLUSIONS
  Although we cannot exclude the role of polymorphism in angiotensinogen and selectin E genes, the prognosis of patients post-PCI in our study was mainly influenced by risk factors related to lipid metabolisms.
authors.affiliation: Department of Heart Failure and Transplantology, Institute of Cardiology, Warsaw, Poland. rywikt@mp.pl
authors.forename: Tomasz M
authors.initials: TM
authors.lastname: Rywik
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Szperl
authors.forename: Rafał
authors.initials: R
authors.lastname: Płoski
authors.forename: Przemysław
authors.initials: P
authors.lastname: Leszek
authors.forename: Marta
authors.initials: M
authors.lastname: Roszczynko
authors.forename: Dariusz
authors.initials: D
authors.lastname: Rynkun
authors.forename: Adam
authors.initials: A
authors.lastname: Witkowski
authors.forename: Paweł
authors.initials: P
authors.lastname: Kurjata
authors.forename: Jerzy
authors.initials: J
authors.lastname: Korewicki
mesh_terms: D000328:Adult; D000368:Aged; D060050:Angina, Stable / Q000235:genetics / Q000628:therapy*; D017130:Angioplasty / Q000379:methods*; D016022:Case-Control Studies; D005500:Follow-Up Studies; D005819:Genetic Markers; D020022:Genetic Predisposition to Disease; D005838:Genotype; D006801:Humans; D018950:Lipopolysaccharide Receptors / Q000235:genetics; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D011110:Polymorphism, Genetic / Q000235:genetics*; D011379:Prognosis; D011446:Prospective Studies; D018343:Receptors, Adrenergic, beta-2 / Q000235:genetics; D017472:Receptors, Interleukin-1 / Q000235:genetics; D012084:Renin-Angiotensin System / Q000235:genetics; D012307:Risk Factors; D011795:Surveys and Questionnaires
chemical_list: D005819:Genetic Markers; D018950:Lipopolysaccharide Receptors; D018343:Receptors, Adrenergic, beta-2; D017472:Receptors, Interleukin-1