Abstract
The aim of the study – to analyze the effect of polymorphism of ACE (Ins / Del) rs4341 on the incidence of restenosis and negative cardiac events after percutaneous coronary interventions (PCI).
Material and methods. The study included 84 patients with ischemic heart disease who had PCI. Patients were under dynamic observation on average for 6.5 ± 0.2 years after the treatment. In all patients, the ACE gene was tested for polymorphism (Ins / Del) rs4341. Patients were divided into 3 groups: 1 group (n = 12) – patients with homozygous genotype II, 2 group (n = 46) – patients with genotype ID, Group 3 (n = 26) – patients with homozygous genotype DD.
Results. The effect of polymorphism of ACE (Ins / Del) rs4341 on the risk of restenosis of stent after PCI was established. The development of stent restenosis was more often diagnosed in carriers of genotype ID. Restenosis of the stent intestine was detected only in carriers of the allele D (with genotypes ID and DD), whereas in the group of carriers of genotype II, there were no restenoses inside the stents (0; 12 (26%), 2 (8%), 1, 2, 3 groups, respectively, p = 0.04). The association of the carrier genotype ID with the risk of restenosis of the stent after PCI was revealed: odds ratio 6.35, 95% confidence interval 1.32–30.4 (χ2 = 6.85, p = 0.03). The frequency of progression of coronary atherosclerosis outside the stenting area groups of patients with different genotypes of ACE did not differ significantly (3 (25%), 9 (20%), 7 (27%), in 1, 2, 3 groups, respectively, p > 0,05). There was no significant effect of genotypes of polymorphism of ACE (Ins / Del) rs4341 on the development of adverse cardiovascular events in the medium-long time after PCI (myocardial infarction after PCI and return of angina after PCI and cardiovascular death).
Conclusion. The study showed the effect of polymorphism of ACE (Ins / Del) on the risk of restenosis of the stent after PCI. The pathogenesis of the formation of restenosis is complicated, many genes participate in it. Further research is needed to study the effect of many genetic variants potentially involved in the pathogenesis of restenosis. The detection of genetic markers associated with a high risk of restenosis may later be the theoretical basis for the development of an individual strategy for revascularization and prevention of cardiac complications in the long term after PCI.
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About the authors
- Buziashvili Yuriy Iosifovich, Dr. Med. Sc., Professor, Academician of the Russian Academy of Sciences, Head of the Clinical Diagnostic Department;
- Koksheneva Inna Valer'evna, Dr. Med. Sc., Senior Researcher, orcid.org/0000-0002-8797-9340;
- Kakauridze Maya Akakievna, Postgraduate;
- Abukov Said Temishevich, Cardiologist; Turakhonov Timur Kurbanalievich, Postgraduate;
- Inauri Ilya Akakievich, Cardiologist
