Angiotensinogen M235T gene polymorphism and recurrent restenosis after repeated percutaneous transluminal coronary angiography

Abstract

The present study was designed to prospectively test the hypothesis that gene polymorphisms of the renin-angiotensin system are associated with recurrent restenosis after repeated percutaneous transluminal coronary angioplasty. Five hundred and eleven patients after first successful angioplasty were characterized with respect to the angiotensinogen M235T, angiotensin-converting enzyme insertion/deletion and angiotensin II type 1 receptor A1166C gene polymorphisms. In 164 of these patients repeated angioplasty on a restenotic lesion was performed. After repeated angioplasty, 46 patients had recurrent restenosis as defined by a greater than 50% progression of residual stenosis. In the recurrent restenosis group there was a statistically significant higher percentage of patients receiving cholesterol-lowering drugs compared with the group of patients without recurrent restenosis. The two groups of patients did not differ with respect to procedural and angiographic parameters. There were significantly more carriers of the angiotensinogen 235T allele in the recurrent restenosis group than in the control group without recurrent restenosis. No differences between the two groups were found with respect to the other gene polymorphisms investigated. According to the results of a multifactorial analysis of variance, only the 235T allele of the angiotensinogen gene and not cholesterol drug therapy independently affected the increase of stenosis at follow-up angiography. In conclusion, the angiotensinogen 235T allele may be an independent predictor for recurrent restenosis after repeated angioplasty.

Renin–angiotensin system and haemostasis gene polymorphisms and outcome after coronary artery bypass graft surgery

“…Similarly, patients with the T allele of the angiotensinogen 235 M/T gene polymorphism have been shown to have elevated plasma angiotensinogen concentrations, which may also reflect an activated renin-angiotensin system. A number of studies have found associations between the angiotensinogen 235T allele and cardiovascular diseases including coronary artery disease [6] and restenosis [7] as well as recurrent restenosis [8] after initial and repeated percutaneous transluminal coronary angioplasty, respectively. The present study was designed to investigate whether the angiotensinogen 235 M/T genotype affects the mid-term outcome after coronary artery bypass graft surgery.…”

Present status of outcome prediction of invasive coronary treatment by using genetic markers

“…The gene coding for the AT1R (AGTR1) contains a single nucleotide sequence variation (c.1166A4C) in the 3 0 -untranslated region, which has been reported to be associated with essential hypertension [Bonnardeaux et al, 1994]. While several studies [Völzke et al, 2000;Hertwig et al, 2002;Hamon et al, 1998;Okamura et al, 1999] failed to demonstrate an association between this sequence variation and restenosis after PTCA, one study [Völzke et al, 2005] reported that the sequence variation may modulate the effects of age on total mortality after CABG surgery.…”

“…In the initial study [Völzke et al, 2000], carriers of the c.803C variant had an odds ratio for developing restenosis after PTCA of 1.43 (95% confidence interval 1.06-1.93) when compared to c.803TT homozygotes. The association of the c.803C variant with an increased risk of restenosis was corroborated in a follow-up study [Hertwig et al, 2002] involving all those patients from the previous study [Völzke et al, 2000] who had suffered from restenosis and were consecutively subjected to a second PTCA procedure. In the follow-up study [Hertwig et al, 2002] carriers of the c.803C variant had an odds ratio for developing recurrent restenosis after repeated PTCA of 2.56 (95% confidence interval 1.11-5.89) when compared to TT homozygotes.…”

“…The association of the c.803C variant with an increased risk of restenosis was corroborated in a follow-up study [Hertwig et al, 2002] involving all those patients from the previous study [Völzke et al, 2000] who had suffered from restenosis and were consecutively subjected to a second PTCA procedure. In the follow-up study [Hertwig et al, 2002] carriers of the c.803C variant had an odds ratio for developing recurrent restenosis after repeated PTCA of 2.56 (95% confidence interval 1.11-5.89) when compared to TT homozygotes. While the AGT c.803C variant may play a role in restenosis after PTCA without stent implantation, it does not seem to be involved in instent restenosis.…”

“…In two consecutive studies [Völzke et al, 2000;Hertwig et al, 2002] the rare AGT c.803C variant was identified as an independent risk factor for restenosis after PTCA [Völzke et al, 2000] and for recurrent restenosis after repeated PTCA [Hertwig et al, 2002]. In the initial study [Völzke et al, 2000], carriers of the c.803C variant had an odds ratio for developing restenosis after PTCA of 1.43 (95% confidence interval 1.06-1.93) when compared to c.803TT homozygotes.…”