Abstract
OBJECTIVE The aim of this study was to evaluate possible interactions among Angiotensin-I converting enzyme genotype, insertion/deletion polymorphism and atherosclerosis of vein grafts in Iranian patients, and characterize their clinical and demographic profile.METHODS In this cross-sectional study, patients who underwent coronary artery bypass graft surgery more than five years ago, were included for angiographic analysis. Atherosclerosis was determined by quantitative angiography and adjusted Gensini score. The gene angiotensin converting enzyme I/D polymorphism was detected by polymerase chain reaction.RESULTS A total of 102 patients participated in this study. Eighty-four patients were male. The frequency distribution of DD, ID and II polymorphism were 23.6%, 62.7% and 13.7% respectively. There were no differences among genotypic groups in age, sex, number of risk factors, number of vein grafts and months since bypass surgery. According to adjusted Gensini score [0.18±0.12 (II) vs. 0.11±0.09 (ID) and 0.1±0.09 (DD) P=0.021] the II genotype was associated with severity of vein graft atherosclerosis.CONCLUSION Although there are conflicting results about gene angiotensin converting enzyme I/D polymorphism and the degree of venous bypass graft degeneration, this study suggests an association between ACE genotype II and atherosclerosis of saphenous vein grafts, however, large samples considering clinical, demographic and ethnic profile are necessary to confirm these results.
Highlights
IntroductionCoronary artery bypass graft surgery (CABG) still remains the standard care for patients with multivessel coronary artery disease comparing to percutaneous coronary intervention (PCI)
According to adjusted Gensini score [0.18±0.12 (II) vs. 0.11±0.09 (ID) and 0.1±0.09 (DD) P=0.021] the II genotype was associated with severity of vein graft atherosclerosis
Conclusion: there are conflicting results about gene angiotensin converting enzyme insertion/ deletion (I/D) polymorphism and the degree of venous bypass graft degeneration, this study suggests an association between angiotensin-converting enzyme (ACE) genotype II and atherosclerosis of saphenous vein grafts, large samples considering clinical, demographic and ethnic profile are necessary to confirm these results
Summary
Coronary artery bypass graft surgery (CABG) still remains the standard care for patients with multivessel coronary artery disease comparing to percutaneous coronary intervention (PCI). This maybe due to its lower rates of major adverse cardiac and cerebrovascular events in short-term and long-term periods[1,2,3,4,5]. A majority of patients receive saphenous vein grafting (SVG) to most vessels, with the exception of the left anterior descending coronary artery[6]. Large diameter and wall characteristics, being plentiful, long and easy harvest has made SVG the most commonly used conduit, but its longevity, as compared with arterial graft, is not satisfying. Thrombosis, intimal hyperplasia and atherosclerosis account for graft failure in early (less than 1 month), subacute (one to 12 months) and late (more than 12 months) post CABG periods[8,9,10,11]
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