Variation in the human soluble epoxide hydrolase gene and risk of restenosis after percutaneous coronary intervention

Silke Kullmann,Mark Lankisch,Hans-Peter Bestehorn,Kirsten Rackebrandt,Georg Haltern,Priska Binner,Reiner Füth,Thomas Scheffold,Eberhard Von Hodenberg,Andreas Huge

doi:10.1186/1471-2261-9-48

Abstract

BackgroundRestenosis represents the major limiting factor for the long-term efficacy of percutaneous coronary intervention (PCI). Several genetic factors involved in the regulation of the vascular system have been described to play a role in the pathogenesis of restenosis. We investigated whether the EPHX2 K55R polymorphism, previously linked to significantly higher risk for coronary heart disease (CHD), was associated with the occurrence of restenosis after PCI. The association with incident CHD should have been confirmed and a potential correlation of the EPHX2 K55R variant to an increased risk of hypertension was analysed.MethodsAn overall cohort of 706 patients was studied: This cohort comprised of 435 CHD patients who had undergone successful PCI. Follow-up coronary angiography in all patients was performed 6 months after intervention. Another 271 patients in whom CHD had been excluded by coronary angiography served as controls. From each patient EDTA-blood was drawn at the baseline ward round. Genomic DNA was extracted from these samples and genotyping was performed by real-time PCR and subsequent melting curve analysis.ResultsIn CHD patients 6 month follow-up coronary angiography revealed a restenosis rate of 29.4%, classified as late lumen loss as well as lumen re-narrowing ≥ 50%.Statistical analysis showed an equal genotype distribution in restenosis patients and non-restenosis patients (A/A 82.0% and A/G + G/G 18.0% versus A/A 82.1% and A/G + G/G 17.9%). Moreover, neither a significant difference in the genotype distribution of CHD patients and controls nor an association with increased risk of hypertension was found.ConclusionThe results of the present study indicate that the EPHX2 K55R polymorphism is not associated with restenosis after PCI, with incidence of CHD, or with an increased risk of hypertension and therefore, can not serve as a predictor for risk of CHD or restenosis after PCI.

Highlights

Restenosis represents the major limiting factor for the long-term efficacy of percutaneous coronary intervention (PCI)
The age of the coronary heart disease (CHD) patients compared to the controls was approximately equal in both groups (61 ± 8.9 versus 59 ± 9.6)
Based on the previously reported association of the EPHX2 K55R polymorphism with incident CHD in an American study population of Caucasian origin [28], we investigated whether the K55R variant allele was associated with restenosis in patients who had undergone pri

Summary

Introduction

Restenosis represents the major limiting factor for the long-term efficacy of percutaneous coronary intervention (PCI). We investigated whether the EPHX2 K55R polymorphism, previously linked to significantly higher risk for coronary heart disease (CHD), was associated with the occurrence of restenosis after PCI. In numerous patients restenosis limits the clinical efficacy of this procedure. Restenosis represents a multifactorial process affected by a wide range of clinical, anatomic and procedural factors [1]. This includes, amongst others, the type of intervention such as PCI with or without intracoronary stent placement, type of stent, the nature of the affected vessels and the baseline characteristics of the patients [2,3,4]. Vessel recoil, negative vascular remodelling and neointimal formation contributes to the development of restenosis [5,6]

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Discussion

Conclusion