NEW YORK (Reuters Health) - Neither homocysteine plasma levels nor two polymorphisms of the methylenetetrahydrofolate reductase (MTHFR) gene are associated with the risk of restenosis after coronary artery stenting, according to a report in the December issue of Arteriosclerosis, Thrombosis, and Vascular Biology.
Elevated homocysteine levels have been linked to the risk of coronary artery disease and outcomes after coronary balloon angioplasty, the authors explain, and two single-nucleotide polymorphisms (SNPs) of MTHFR have been inconsistently linked with restenosis after coronary artery interventions.
Dr. Werner Koch and colleagues from Technische Universitat Munchen, Munchen, Germany investigated whether homocysteine levels and polymorphisms 677C/T and 1298A/C of the MTHFR gene influenced the rate of restenosis or other adverse events after stenting of atherosclerotic coronary arteries in 800 patients.
Homocysteine levels were significantly higher among carriers of the 677TT genotype than among patients with 677CC or 677CT, the authors report, but homocysteine levels did not differ with 1298A/C genotypes.
Compared with patients having homocysteine plasma levels of 11.6 micromoles/L or below, patients with homocysteine plasma levels above 11.6 micromoles/L did not differ in the incidences of death, death or myocardial infarction, or urgent target vessel revascularization. The rates of these adverse events also did not differ according to 677C/T or 1298A/C genotype, the researchers found.
Moreover, they note, restenosis rates, the need for restenosis-driven re-intervention, and one-year clinical outcomes did not differ significantly according to homocysteine level or MTHFR genotype.
“The results presented here strongly suggest that elevated plasma homocysteine concentrations are not associated with an increased risk of restenosis in patients treated with stenting in coronary arteries,” the authors conclude.
“In addition,” they write, “the results provide evidence that the 677C/T SNP and the 1298A/C SNP of the MTHFR gene, either alone or in combination, are not related to in-stent restenosis.”
Source: Arterioscler Thromb Vasc Biol 2003;23:2229-2234. [ Google search on this article ]
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