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High rate of in-stent restenosis after coronary intervention in carriers of the mutant mannose-binding lectin allele.

ABSTRACT: In-stent restenosis occurs in 10-30% of patients following bare metal stent (BMS) implantation and has various risk factors. Mannose-binding lectin (MBL) is known to have effect on the progression of atherosclerosis. Single nucleotide polymorphisms (SNP) of the MBL2 gene intron 1 (codon 52, 54, 57) are known to modulate the bioavailability of the MBL protein. Our aim was to identify the association of these polymorphisms of the MBL gene in the occurrence of in-stent restenosis after coronary artery bare metal stent implantation.In a non-randomized prospective study venous blood samples were collected after recoronarography from 225 patients with prior BMS implantation. Patients were assigned to diffuse restenosis group and control group based on the result of the coronarography. MBL genotypes were determined using quantitative real-time PCR. Proportion of different genotypes was compared and adjusted with traditional risk factors using multivariate logistic regression.Average follow-up time was 1.0 (+?-?1.4) year in the diffuse restenosis group (N?=?117) and 2.7 (+?-?2.5) years in the control group (N?=?108). The age, gender distribution and risk status was not different between study groups. Proportion of the MBL variant genotype was 26.8% (29 vs. 79 normal homozygous) in the control group and 39.3% (46 vs. 71 normal homozygous) in the restenosis group (p?=?0.04). In multivariate analysis the mutant allele was an independent risk factor (OR?=?1.96, p?=?0.03) of in-stent restenosis.MBL polymorphisms are associated with higher incidence of development of coronary in-stent restenosis. The attenuated protein function in the mutant allelic genotype may represent the underlying mechanism.

SUBMITTER: Bagyura Z

PROVIDER: S-EPMC5217188 | biostudies-literature | 2017 Jan

REPOSITORIES: biostudies-literature

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High rate of in-stent restenosis after coronary intervention in carriers of the mutant mannose-binding lectin allele.

Bagyura Zsolt Z Kiss Loretta L Berta Balázs B Szilágyi Ágnes Á Hirschberg Kristóf K Széplaki Gábor G Lux Árpád Á Szelid Zsolt Z Soós Pál P Merkely Béla B

BMC cardiovascular disorders 20170105 1

<h4>Background</h4>In-stent restenosis occurs in 10-30% of patients following bare metal stent (BMS) implantation and has various risk factors. Mannose-binding lectin (MBL) is known to have effect on the progression of atherosclerosis. Single nucleotide polymorphisms (SNP) of the MBL2 gene intron 1 (codon 52, 54, 57) are known to modulate the bioavailability of the MBL protein. Our aim was to identify the association of these polymorphisms of the MBL gene in the occurrence of in-stent restenosis ...[more]

PMID: 28056798

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Project description:In-stent restenosis (ISR) is the most common complication associated with percutaneous coronary intervention (PCI). Although some studies have reported an association between lectin-like oxidized low-density lipoprotein receptor-1 (LOX-1) and ISR, not enough clinical validation data are available to support this link. Here, we report our cross-sectional study aimed at exploring the feasibility of LOX-1 as a biomarker for the prognostic diagnosis of patients undergoing PCI.Three groups were included: ISR group, including 99 patients with ISR diagnosed with coronary arteriography (CAG) after PCI; lesion group, comprising 87 patients with coronary artery stenosis (<50%) diagnosed with CAG after PCI; and control group, consisting of 96 volunteers with no coronary artery disease. The levels of LOX-1 were measured in each patient by using an enzyme-linked immunosorbent assay, and their general information as well as laboratory parameters were recorded and followed up during a period of 2 years.LOX-1 levels gradually increased after PCI along with the progression of the lesion in the 3 groups. The levels of LOX-1 were significantly higher in the ISR group than in the other 2 groups (P?<?.001). LOX-1 levels were correlated with the levels of uric acid (UA) (r?=?0.289, P?=?.007), creatinine (CREA) (r?=?.316, P?=?.003), and high-density lipoprotein cholesterol (HDL-C) (r?=?-0.271, P?=?.012), whereas no statistically significant correlation was detected with the Gensini score (r?=?0.157, P?=?.141). The sensitivity and specificity of LOX-1 were 81.5% and 55.7%, respectively, with the most optimal threshold (5.04??g/L). The area under curve (AUC) of the receiver operator characteristic (ROC) curve of LOX-1 was 0.720, and LOX-1 had the highest AUC compared with CREA, UA, and HDL-C, both individually and in combination.A high level of LOX-1 in the early period after PCI has a certain predictive power and diagnostic value for ISR. However, the level of LOX-1 is not related to the Gensini score of coronary artery after PCI, and CREA and UA, which are weakly related to LOX-1, have no obvious synergy in the diagnosis of ISR with LOX-1.

Dataset Information

High rate of in-stent restenosis after coronary intervention in carriers of the mutant mannose-binding lectin allele.

Publications

High rate of in-stent restenosis after coronary intervention in carriers of the mutant mannose-binding lectin allele.

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