The angiotensinogen gene 235T variant is associated with an increased risk of restenosis after percutaneous transluminal coronary angioplasty.
The angiotensinogen gene 235T variant is associated with an increased risk of restenosis after percutaneous transluminal coronary angioplasty.
复制标题
血管紧张素原基因 235T 变异与经皮冠状动脉成形术后再狭窄风险增加相关。
作者：
H. Völzke;Sabine Hertwig;R. Rettig;W. Motz
经皮冠状动脉腔内成形术(PTCA)的治疗效果受到30-40%的患者再狭窄的限制。其潜在机制目前还不是很清楚。除了临床和血管造影术变量外，遗传因素也可能参与其中。在本研究中，我们研究了511例接受PTCA(无支架)和随访血管造影术的患者的血管紧张素原T174M和M235T、血管紧张素转换酶(ACE)I/D和血管紧张素II 1型受体A1166C基因多态性与再狭窄的关系。临床和血管造影变量也被认为是再狭窄的可能预测因素。狭窄严重程度通过血管造影的肉眼检查来评估。总共有160名患者发生了再狭窄，其定义是与血管成形术后立即发现的结果相比，在随访血管造影时扩张节段的直径缩小了50%以上。再狭窄组血管紧张素原235T等位基因携带者和血管紧张素转换酶基因DD型患者明显多于无再狭窄组，但经多因素分析，只有血管紧张素原235T等位基因(而不是血管紧张素转换酶基因DD型)与再狭窄显著相关。在其他基因多态性方面，两组之间没有发现差异。随后发生再狭窄的患者在PTCA前狭窄程度较高，病变较严重，PTCA后即刻残余狭窄较少。提示血管紧张素原M235T基因多态性可能是PTCA术后再狭窄的独立预测因子。
The therapeutic benefit of percutaneous transluminal coronary angioplasty (PTCA) is limited by restenosis in 30-40% of patients. The underlying mechanisms are currently not well understood. Besides clinical and angiographic variables, genetic factors may be involved. In the present study, we investigated the associations between the angiotensinogen T174M and M235T, the angiotensin I-converting enzyme (ACE) I/D and the angiotensin II type 1 receptor A1166C gene polymorphisms and restenosis in 511 patients who had undergone successful PTCA (without stenting) and follow-up angiography. Clinical and angiographic variables were also considered as possible predictors of restenosis. Stenosis severity was estimated by visual inspection of the angiograms. Altogether, 160 patients had restenosis, as defined by a greater than 50% reduction in the diameter of the dilated segment at follow-up angiography compared with the findings immediately following angioplasty. There were significantly more carriers of the angiotensinogen 235T allele and more patients with the ACE DD genotype in the restenosis group than in the no restenosis group, but only the angiotensinogen 235T allele (and not the ACE DD genotype) remained significantly associated with restenosis following multifactorial analyses. No differences between the two groups were found with respect to the other gene polymorphisms. Patients who subsequently developed restenosis had a higher degree of stenosis and more severe lesions before PTCA, as well as less residual stenosis immediately after PTCA. We conclude that the angiotensinogen M235T gene polymorphism may be an independent predictor of restenosis after PTCA.
影响因子：
15.9
作者：
Inoue, I;Nakajima, T;Lalouel, JM
通讯作者：
Lalouel, JM
影响因子：
15.9
作者：
RAKUGI, H;KIM, DK;PRATT, RE
通讯作者：
PRATT, RE