OBJECTIVE: We previously found a -786T/C polymorphism in the 5'-flanking region of the endothelial nitric oxide synthase (eNOS) gene and reported that this polymorphism is strongly associated with coronary spasm. In this study, we examined whether the polymorphism is a prognostic marker in coronary spasm patients. METHODS AND RESULTS: We examined the clinical courses of 201 consecutive patients with coronary spasm who were admitted to our institution: 146 patients with the -786T/T genotype; 50 patients with the -786C/T genotype; and five patients with the -786C/C genotype. The mean follow-up period was 76+/-60 months. All the patients took calcium channel blockers and/or nitrate during the follow-up period. In this study, no patients died due to a cardiac event. About 25 patients were readmitted owing to cardiovascular disease. Out of these 25 patients, 23 patients were readmitted owing to a reattack of coronary spasm. The -786C allele was significantly associated with readmission due to coronary spasm (P=0.0072, odds ratio: 3.37 in the dominant effect). Kaplan-Meier analysis revealed that the occurrence of readmission was significantly higher in the patients with the -786C allele than in the patients without the -786C allele (P=0.0079). Further, multiple logistic regression analysis revealed that the -786T/C polymorphism was an independent predictor for readmission due to reattack of coronary spasm (P=0.006; relative risk=3.590). CONCLUSIONS: The eNOS -786C allele is an independent risk factor for readmission due to a recurrent attack of coronary spasm in patients with coronary spasm, even if the patients have taken calcium channel blockers and/or nitrate.
OBJECTIVE: We previously found a -786T/C polymorphism in the 5'-flanking region of theendothelial nitric oxide synthase (eNOS) gene and reported that this polymorphism is strongly associated with coronary spasm. In this study, we examined whether the polymorphism is a prognostic marker in coronary spasmpatients. METHODS AND RESULTS: We examined the clinical courses of 201 consecutive patients with coronary spasm who were admitted to our institution: 146 patients with the -786T/T genotype; 50 patients with the-786C/T genotype; and five patients with the -786C/C genotype. The mean follow-up period was 76+/-60 months. All thepatients took calcium channel blockers and/or nitrate during the follow-up period. In this study, no patients died due to a cardiac event. About 25 patients were readmitted owing to cardiovascular disease. Out of these 25 patients, 23 patients were readmitted owing to a reattack of coronary spasm. The -786C allele was significantly associated with readmission due to coronary spasm (P=0.0072, odds ratio: 3.37 in the dominant effect). Kaplan-Meier analysis revealed that the occurrence of readmission was significantly higher in thepatients with the -786C allele than in thepatients without the -786C allele (P=0.0079). Further, multiple logistic regression analysis revealed that the -786T/C polymorphism was an independent predictor for readmission due to reattack of coronary spasm (P=0.006; relative risk=3.590). CONCLUSIONS:TheeNOS -786C allele is an independent risk factor for readmission due to a recurrent attack of coronary spasm in patients with coronary spasm, even if thepatients have taken calcium channel blockers and/or nitrate.
Authors: Robert M Starke; Grace H Kim; Ricardo J Komotar; Zachary L Hickman; Eric M Black; Maritza B Rosales; Christopher P Kellner; David K Hahn; Marc L Otten; John Edwards; Tao Wang; James J Russo; Stephan A Mayer; Edward S Connolly Journal: J Cereb Blood Flow Metab Date: 2008-03-05 Impact factor: 6.200
Authors: S Karovic; Y Wen; T G Karrison; G L Bakris; M R Levine; L K House; K Wu; V Thomeas; M A Rudek; J J Wright; E E W Cohen; G F Fleming; M J Ratain; M L Maitland Journal: Clin Pharmacol Ther Date: 2014-03-17 Impact factor: 6.875