Liu Zhao-ping, Huo Yong, Li Jian-ping, Zhang Yan, Xue Lin, Zhao Chun-yu, Hong Xiu-mei, Huang Ai-qun, Gao Wei
Department of Cardiology, First Hospital of Peking University, Beijing 100034, China.
Chin Med J (Engl). 2004 Feb;117(2):172-5.
Inflammation is a major cause of restenosis after coronary stenting. Intercellular adhesion molecule-1 (ICAM-1) is an important adhesion molecule that plays a key role in the tight adhesion between leukocytes and vascular endothelium. The object of this study was to investigate the association between the K469E polymorphism of the ICAM-1 gene and restenosis after coronary stenting in North Chinese population.
The ICAM-1 K469E polymorphism was genotyped using polymerase chain reaction-restriction fragment length polymorphism method in 124 patients who had undergone coronary stenting and coronary angiography at least 3 months earlier. Information on clinical risk factors and procedure-related data were also collected.
Of 124 enrolled patients in total, there were 72 cases of in-stent restenosis. The restenosis rate in this population was 58.1%. The frequencies of the three possible genotypes of the ICAM-1 K469E polymorphism were: KK genotype 50.8%, EE genotype 41.9%, and EK genotype 41.9%. Among restenosis patients, the frequency of the KK genotype was 58.3% and the frequency of E allele carriers was 41.7%. Among non-restenosis patients, the frequency of the KK genotype was 40.4%, and the frequency of E allele carriers was 59.6%. The distribution of these two genotype groups between restenosis and non-restenosis patients was significantly different (P = 0.049). Using multivariate logistic regression, the difference between the two groups was more apparent. The odds ratio of KK homozygotes vs E allele carriers was 2.6, with 95% confidence interval 1.2 - 5.8 (P = 0.018). After grading of risk factors, we found that the KK genotype was a stronger predictor of in-stent restenosis in obesity or hyperlipemia patients, with an odds ratio of 9.3 and 3.7, respectively (P < 0.05).
In our study population, KK homozygotes of the ICAM-1 codon 469 mutation had a higher risk of restenosis after coronary stenting, especially in the case of obese or hyperlipemia patients.
炎症是冠状动脉支架置入术后再狭窄的主要原因。细胞间黏附分子-1（ICAM-1）是一种重要的黏附分子，在白细胞与血管内皮细胞的紧密黏附中起关键作用。本研究的目的是探讨中国北方人群中ICAM-1基因K469E多态性与冠状动脉支架置入术后再狭窄之间的关联。
采用聚合酶链反应-限制性片段长度多态性方法，对124例至少在3个月前接受冠状动脉支架置入术和冠状动脉造影的患者进行ICAM-1 K469E多态性基因分型。同时收集临床危险因素和手术相关数据。
在总共124例入选患者中，有72例发生支架内再狭窄。该人群的再狭窄率为58.1%。ICAM-1 K469E多态性三种可能基因型的频率分别为：KK基因型50.8%，EE基因型41.9%，EK基因型41.9%。在再狭窄患者中，KK基因型频率为58.3%，E等位基因携带者频率为41.7%。在无再狭窄患者中，KK基因型频率为40.4%，E等位基因携带者频率为59.6%。这两种基因型组在再狭窄患者和无再狭窄患者之间的分布有显著差异（P = 0.049）。采用多因素logistic回归分析，两组之间的差异更为明显。KK纯合子与E等位基因携带者的比值比为2.6，95%置信区间为1.2 - 5.8（P = 0.018）。对危险因素进行分级后，我们发现KK基因型在肥胖或高脂血症患者中是支架内再狭窄更强的预测因子，比值比分别为9.3和3.7（P < 0.05）。
在我们的研究人群中，ICAM-1密码子469突变的KK纯合子在冠状动脉支架置入术后发生再狭窄的风险较高，尤其是在肥胖或高脂血症患者中。
