PlA polymorphism of platelet glycoprotein IIIa and risk of restenosis after coronary stent placement.
PlA polymorphism of platelet glycoprotein IIIa and risk of restenosis after coronary stent placement.
复制标题
血小板糖蛋白IIIa的PLA多态性与冠状动脉支架置入后再狭窄的风险。
作者：
A. Kastrati;A. Schömig;M. Seyfarth;W. Koch;S. Elezi;C. Böttiger;J. Mehilli;K. Schömig;N. Beckerath
背景
血小板在经皮冠状动脉介入治疗后的再狭窄过程中发挥着核心作用。血小板糖蛋白 IIIa (PlA) 的多态性与冠状动脉血栓形成的较高风险相关。我们设计这项前瞻性研究是为了检验糖蛋白 IIIa 的 PlA 多态性与冠状动脉支架置入后再狭窄风险增加相关的假设。
方法和结果
该研究包括 1150 名连续成功放置冠状动脉支架并进行 6 个月冠状动脉造影随访的患者。研究的终点是随访时血管造影再狭窄（>/=50%直径狭窄）的发生率。在 1150 名患者中，72.5% 为 PlA1 纯合子，24.7% 为杂合子 (PlA1/A2)，2.8% 为 PlA2 纯合子。携带PlA2等位基因的患者表现出比不携带PlA2等位基因的患者显着更高的再狭窄率（47%对38%；OR，1.42；95% CI，1.09至1.84）。 PlaA2 纯合子携带者的风险最高（再狭窄率为 53.1%）。在对一些临床和血管造影特征进行调整后，PlA2等位基因的存在仍然是再狭窄的一个显着独立的危险因素（调整后的OR，1.35；95％CI，1.07至1.70）。 PLA2 等位基因对女性再狭窄的影响更大。患有PlA2的女性再狭窄率为52%，而PlA1纯合子女性的再狭窄发生率为33%（OR，2.21；95% CI，1.27至3.85）。
结论
这项研究表明糖蛋白 IIIa 的 PlA 多态性与冠状动脉支架置入后再狭窄的风险之间存在显着相关性。 PlaA2 等位基因纯合子患者和女性患者的风险更为明显。
BACKGROUND
Platelets play a central role in the process of restenosis after percutaneous coronary interventions. A polymorphism of platelet glycoprotein IIIa (PlA) has been associated with a higher risk of coronary thrombosis. We designed this prospective study to test the hypothesis that PlA polymorphism of glycoprotein IIIa is associated with an increased risk for restenosis after coronary stent placement.
METHODS AND RESULTS
The study included 1150 consecutive patients with successful coronary stent placement and 6-month follow-up with coronary angiography. The end point of the study was the incidence of angiographic restenosis (>/=50% diameter stenosis) at follow-up. Of the 1150 patients, 72.5% were homozygous for PlA1, 24.7% were heterozygous (PlA1/A2), and 2.8% were homozygous for PlA2. Patients with the PlA2 allele demonstrated a significantly higher restenosis rate than did those without (47% versus 38%; OR, 1.42; 95% CI, 1.09 to 1.84). The risk was highest in homozygous carriers of PlA2 (53.1% restenosis rate). After adjustment for several clinical and angiographic characteristics, the presence of the PlA2 allele remained a significantly independent risk factor for restenosis (adjusted OR, 1.35; 95% CI, 1.07 to 1.70). The influence of the PlA2 allele on restenosis was stronger in women. Women with PlA2 had a restenosis rate of 52% compared with the 33% incidence among women homozygous for PlA1 (OR, 2.21; 95% CI, 1.27 to 3.85).
CONCLUSIONS
This study showed a significant association between the PlA polymorphism of glycoprotein IIIa and the risk of restenosis after coronary stent placement. The risk was more pronounced in patients homozygous for PlA2 allele and in female patients.
影响因子：
37.8
作者：
ELLIS, SG;VANDORMAEL, MG;BULLE, TM
通讯作者：
BULLE, TM
影响因子：
158.5
作者：
Weiss, EJ;Bray, PF;GoldschmidtClermont, PJ
通讯作者：
GoldschmidtClermont, PJ
单链构象多态性分析是鉴定糖蛋白IIIa基因突变和多态性的快速有效的方法。
影响因子：
20.3
作者：
Jin,Y;Dietz,HC;Nurden,A;Bray,PF
通讯作者：
Bray,PF