NEW YORK (Reuters Health) - Heme oxygenase-1 (HO-1) gene promoter microsatellite polymorphism is associated with restenosis after coronary stenting, suggesting that other procedures might be advisable in carriers, Taiwanese researchers report in the January issue of the European Heart Journal.
HO-1 is involved in mechanisms influencing neointimal formation after vascular injury and a dinucleotide GT repeat in the promoter region has a length polymorphism that modulates the level of gene transcription.
As senior investigator Dr. Shing-Jong Lin told Reuters Health, “genetic variation in the HO-1 gene may modify the long-term prognosis after coronary stenting.”
Dr. Lin of Taipei Veterans General Hospital and colleagues came to this conclusion after following 323 patients who successfully underwent coronary stenting.
In this population, the repeat numbers of the GT microsatellite polymorphism ranged from 16 to 38. Compared with those who had less than 26 GT repeats, those with a longer sequence (L) on either allele had an adjusted odds ratio of 3.74 for angiographic restenosis.
This association was particularly pronounced in patients with small coronary arteries or complex lesions before stenting. Moreover, carriers of the L/L genotype had an adjusted odds ratio of 3.26 for adverse cardiac events during follow-up.
Thus, Dr. Lin concluded, it is important “to identify the subgroup of patients who may not benefit from stenting for their coronary artery disease. Alternative therapies, such as bypass surgery, should be first considered in these patients.”
Source: Eur Heart J 2004;25:39-47. [ Google search on this article ]
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