Role of PLA2 polymorphism on clinical events after percutaneous coronary intervention

Abstract

We examined the relationship between the PLA2 polymorphism of the platelet GPIIIa receptor and major adverse cardiac events (MACE) after percutaneous coronary intervention (PCI). PLA2 polymorphism has been associated with increased thrombosis and myocardial infarction. The association of PlA2 with MACE post-PCI has not been determined. 200 patients with normal baseline CKMB undergoing non-urgent PCI for symptomatic coronary artery disease were tested for the PLA2 polymorphism and followed for 1 year while on aspirin and clopidogrel. MACE were recorded and adjudicated by an independent, blinded committee. Baseline demographic and lesion characteristics, platelet aggregation, activated clotting time and use of GP Ilb/llla blockers were similar between the 2 groups. The normal (A1A1), heterozygous (A1A2), and homozygote (A2A2) variants were found in 144 (72%), 55 (27.5%), and 1 (0.5%) patients, respectively. The presence of the PLA2 genetic polymorphism had no influence on 1-year MACE: 7.1% for the A1A1 group versus 6.5% for the A1A2 group (P=NS). The rate of any CKMB elevation post-PCI was 39% vs. 38% respectively (P=NS). In this study, the GPIIIa PlA2 polymorphism was frequent (27.5%), but the homozygous variant was very infrequent (0.5%). The presence of PLA2 had no influence on peri-procedural or one-year clinical outcomes.