Stangl K, Cascorbi I, Stangl V, Laule M, Mrozikiewicz P M, Schwarz M, Felix S B, Theres H, Baumann G, Roots I
Medizinische Klinik und Poliklinik, Campus Mitte, Berlin, Germany.
Am Heart J. 2000 Jul;140(1):170-5. doi: 10.1067/mhj.2000.107551.
Contradictory reports exist concerning the role of the angiotensin II type 1 receptor A1166C polymorphism as a coronary risk factor. Moreover, it is unknown whether the A1166C polymorphism is associated with thrombotic complications after coronary catheter interventions.
We investigated the role of the A1166C polymorphism as a risk factor in 1000 patients with coronary artery disease (CAD) and in 1000 age- and sex-matched controls. A total of 649 patients receiving interventions (270 coronary angioplasty, 102 atherectomy, and 277 stenting) were investigated for a 30-day composite end point including target vessel revascularization, myocardial infarction, or death.
The composite end point was reached by 42 patients (6.5%) without evidence that the C allele was associated with excess procedural risk (odds ratio 0.93; 95% confidence interval 0.79-1.75; P =.82). Further analyses by device failed to show linkage with adverse events complicating coronary angioplasty, atherectomy, and stenting. Moreover, in the entire CAD group (n = 1000), the polymorphism even showed a trend to underrepresentation (odds ratio 0.83; 95% confidence interval 0.69-1. 004, P =.054).
These results indicate that the A1166C polymorphism neither represents a risk factor for adverse events complicating coronary interventions nor seems to have significant impact on further long-term processes such as development and severity of CAD.
关于血管紧张素II 1型受体A1166C多态性作为冠状动脉危险因素的作用，存在相互矛盾的报道。此外，尚不清楚A1166C多态性是否与冠状动脉导管介入术后的血栓形成并发症相关。
我们在1000例冠状动脉疾病（CAD）患者和1000例年龄及性别匹配的对照中，研究了A1166C多态性作为危险因素的作用。对总共649例接受介入治疗的患者（270例行冠状动脉血管成形术，102例行斑块旋切术，277例行支架置入术）进行了为期30天的复合终点研究，复合终点包括靶血管血运重建、心肌梗死或死亡。
42例患者（6.5%）达到复合终点，没有证据表明C等位基因与额外的手术风险相关（优势比0.93；95%置信区间0.79 - 1.75；P = 0.82）。按器械进行的进一步分析未能显示与冠状动脉血管成形术、斑块旋切术和支架置入术并发的不良事件存在关联。此外，在整个CAD组（n = 1000）中，该多态性甚至呈现出代表性不足的趋势（优势比0.83；95%置信区间0.69 - 1.004，P = 0.054）。
这些结果表明，A1166C多态性既不是冠状动脉介入术后并发不良事件的危险因素，也似乎对CAD的发展和严重程度等进一步的长期过程没有显著影响。
