NEW YORK (Reuters Health) - Patients with a specific polymorphism in the CD14 gene promoter are at increased risk of coronary stent restenosis, Japanese researchers report. The polymorphism raises levels of soluble of CD14, which may play an important role in the process of restenosis.
In the March issue of the International Journal of Cardiology, Dr. Kazunori Shimada and colleagues at the Juntendo University School of Medicine in Tokyo explain that CD14 has a role in the activation of monocytes, macrophages and neutrophils. In addition, soluble CD14/lipopolysaccharide complexes stimulate endothelial cells and smooth muscle cells.
In 129 patients who underwent elective coronary stenting, the researchers analyzed the association between restenosis and prevalence of the C(-260)-to-T polymorphism of the CD14 gene promoter, as well as levels of soluble CD14.
“The prevalence of the T/T genotype and the concentration of soluble CD14 were significantly higher in the restenosis group than in the no-restenosis group,” the investigators report.
They found the restenosis rate was 10% in patients without the polymorphism and with soluble CD14 concentrations below the 50th percentile, compared with 50% in patients with the polymorphism and soluble CD14 concentrations above the 50th percentile.
On multivariate analysis, the relative risk for restenosis with the T/T genotype was 2.6, according to the authors.
“The activation of monocytes/macrophages, endothelial cells and smooth muscle cells mediated by CD14 and/or soluble CD14 may play an important role in the restenosis process,” Dr. Shimada and colleagues conclude.
They add, “This new approach to risk stratification of in-stent restenosis may be useful in clinical settings.”
Source: Int J Cardiol 2004;94:87-92. [ Google search on this article ]
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