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糖蛋白Ia基因C807T多态性与冠状动脉支架置入术后30天内主要不良心脏事件风险

Glycoprotein Ia gene C807T polymorphism and risk for major adverse cardiac events within the first 30 days after coronary artery stenting.

作者信息

von Beckerath N, Koch W, Mehilli J, Böttiger C, Schömig A, Kastrati A

机构信息

Deutsches Herzzentrum and 1. Medizinische Klinik rechts der Isar, Technische Universität München, Munich, Germany.

出版信息

Blood. 2000 Jun 1;95(11):3297-301.

Abstract

The glycoprotein complex Ia/IIa (GP Ia/IIa) is a major collagen receptor on platelets and other cell types. Recently, linked polymorphisms within the coding region of the GP Ia gene (C807T and G873A) were identified that are related to GP Ia/IIa surface expression. The T807/A873 allele is associated with high expression, whereas the C807/G873 allele is associated with low surface expression of GP Ia/IIa. Subsequently, the T807 allele was found to be associated with coronary and cerebral infarction in younger patients. Platelet adhesion to the vessel wall plays a pivotal role in thrombosis after coronary artery stent placement. The goal of this study was to test whether C807T polymorphism is associated with a higher incidence of thrombotic events following coronary stenting. Consecutive patients treated with coronary stent placement (n = 1797) were genotyped for C807T polymorphism with polymerase chain reaction and allele-specific fluorogenic probes. The composite end point was defined as death, myocardial infarction, or urgent target vessel revascularization within 30 days of stent implantation. The genotype distribution of the study population was CC in 36.5%, CT in 46.7%, and TT in 16.8% of the patients. The incidence of the composite end point was 6.5% in T allele carriers and 5.3% in noncarriers (odds ratio for T allele carriage 1.23 [95% confidence interval, 0.81-1.86], P =.33). After adjusting for other baseline characteristics, the odds ratio for the composite end point was 1.15 (0.76-1.75). Therefore, C807T genotype has no significant influence on the major adverse events occurring after coronary artery stenting.

摘要

糖蛋白复合物Ia/IIa(GP Ia/IIa)是血小板及其他细胞类型上的主要胶原受体。最近,在GP Ia基因编码区发现了连锁多态性(C807T和G873A),这些多态性与GP Ia/IIa的表面表达相关。T807/A873等位基因与高表达相关,而C807/G873等位基因与GP Ia/IIa的低表面表达相关。随后,发现T807等位基因与年轻患者的冠状动脉和脑梗死相关。血小板黏附于血管壁在冠状动脉支架置入术后的血栓形成中起关键作用。本研究的目的是检测C807T多态性是否与冠状动脉支架置入术后血栓事件的较高发生率相关。对连续接受冠状动脉支架置入治疗的患者(n = 1797),采用聚合酶链反应和等位基因特异性荧光探针进行C807T多态性基因分型。复合终点定义为支架植入后30天内死亡、心肌梗死或紧急靶血管血运重建。研究人群的基因型分布为CC占36.5%,CT占46.7%,TT占16.8%。T等位基因携带者的复合终点发生率为6.5%,非携带者为5.3%(T等位基因携带的比值比为1.23 [95%置信区间,0.81 - 1.86],P = 0.33)。在调整其他基线特征后,复合终点的比值比为1.15(0.76 - 1.75)。因此,C807T基因型对冠状动脉支架置入术后发生的主要不良事件无显著影响。

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