Angiotensin-converting enzyme insertion/deletion polymorphism does not influence the restenosis rate after coronary stent implantation

Episode von Medizin - Open Access LMU - Teil 13/22 von Ludwig-Maximilians-Universität München · 1. Januar 2002

Background. Experimental studies have shown an activation of the angiotensin-converting enzyme (ACE) system as a response to endothelial injury. Recent publications have elucidated the hypothesis that the ACE gene polymorphism may influence the level of late luminal loss after coronary stent implantation. It is still unclear whether the polymorphism of the angiotensin gene is a major predictor of the extent of neointimal hyperplasia. In this multicenter study, we therefore tested the relationship between the ACE gene polymorphism and the restenosis rate after coronary stent implantation. Methods: As a substudy of the optimization with intracoronary, ultrasound (ICUS) to reduce stent restenosis (OPTICUS) study, we analyzed ACE serum levels and the ACE gene polymorphism in 154 patients at 9 different centers. All patients underwent elective coronary stent implantation in a stenosis of a major coronary vessel. Balloon inflations were repeated until a satisfactory result was achieved in on-line quantitative coronary angiography or ICUS fulfilling the OPTICUS study criteria. After follow-up of 6 months, all patients underwent reangiography tinder identical projections as the baseline procedure. A blinded quantitative analysis of the initial procedure as well as the follow-up examinations were performed by an independent core laboratory. ACE gene polymorphism and ACE serum activity were measured at the 6-month follow-up in a double-blinded setting. Results: With respect to the ACE gene polymorphism, there were three subgroups: DID genotype (48 patients), ID (83 patients) and 11 (23 patients). The subgroups did not differ in regard to age, gender, extent of coronary artery disease, stenosis length, initial degree of stenosis or degree of stenosis after stent implantation. In all, 39 patients (25.3%) had significant restenosis: 12 DD patients (25.0%), 18 ID patients (21.7%) and 9 II patients (39.1%) (odds ratio 2.164, 95% confidence interval 0.853-5.493). We obtained the following results for ACE serum levels: 0.53 mumol/l/s in the DD subgroup, 0.29 mumol/l/s in the ID.

Weitere Episoden von „Medizin - Open Access LMU - Teil 13/22“

• An autocrine role for pituitary GABA: Activation of GABA-B receptors and regulation of growth hormone levels 1. Januar 2002
• Anti-Saccharomyces cerevisiae antibodies in patients with inflammatory bowel disease and their first-degree relatives: Potential clinical value 1. Januar 2002
• CADASIL: A monogenic condition causing stroke and subcortical vascular dementia 1. Januar 2002
• Calcitonin receptor-like receptor is expressed on gastrointestinal immune cells 1. Januar 2002
• Candidate genes colocalized to linkage regions in inflammatory bowel disease 1. Januar 2002
• Chronological relationship between antisocial personality disorder and alcohol dependence 1. Januar 2002
• Clozapine as add-on medication in the maintenance treatment of bipolar and schizoaffective disorders - A case series 1. Januar 2002
• Cold stress in captive great apes recorded in incremental lines of dental cementum 1. Januar 2002
• Comparison of regional blood flow values measured by radioactive and fluorescent microspheres 1. Januar 2002
• Comparison of the new OPS Imaging technique with intravital microscopy: Analysis of the colon microcirculation 1. Januar 2002
• Cutaneous eccrine glands of the foot pads of the rock hyrax (Procavia capensis, Hyracoidea, mammalia) 1. Januar 2002
• Differentiation-dependent glycosylation of cells in squamous cell epithelia detected by a mammalian lectin 1. Januar 2002
• Effect of Early Enteral Feeding on Apolipoprotein AI Levels and High-Density Lipoprotein Heterogeneity in Preterm Infants 1. Januar 2002
• Effects of ultra-purified polymerized bovine hemoglobin on local tissue oxygen tension in striated skin muscle - An efficacy study in the hamster 1. Januar 2002
• Acrylamide: Increased concentrations in homemade food and first evidence of its variable absorption from food, variable metabolism and placental and breast milk transfer in humans 1. Januar 2002

Alle Episoden von Medizin - Open Access LMU - Teil 13/22 · Mehr Bildung-Podcasts