BACKGROUND: Coronary stents are an effective treatment for selected coronary stenoses. However, thrombosis of the stented segment is a major adverse complication. Platelet aggregation has a key role in stent thrombosis. We investigated whether a polymorphism of platelet glycoprotein IIIa gene (PIA2) is associated with an increased risk of coronary stent thrombosis. METHODS: 318 consecutive patients were followed up for 30 days after coronary stent insertion. The primary endpoints were death, myocardial infarction, stent-vessel occlusion, and coronary artery bypass surgery. Gel electrophoresis of PCR products was used to identify the PIA1 and PIA2 alleles. The relative risk of stent occlusion was calculated from the odds ratio on logistic regression analysis. FINDINGS: 63 (19.8%) of patients had the PIA2 allele and 255 (80.2%) were homozygous for PIA1. Baseline clinical, angiographic, and procedural features did not differ between the groups with and without the PIA2 allele. Occlusion of the stent vessel occurred in five (1.9%) patients homozygous for PIA1 and six (9.5%) patients with PIA2 allele (odds ratio 5.26 [95% CI 1.55-17.85]). On multivariate regression analysis PIA1/A2 genotype was the only significant independent predictor of stent thrombosis. INTERPRETATION: Patients with the pIA2 allele have an increased risk of coronary stent thrombosis, which may warrant antiplatelet therapy with glycoprotein-IIb/IIIa inhibitors, although bleeding complications may also increase.
BACKGROUND: Coronary stents are an effective treatment for selected coronary stenoses. However, thrombosis of the stented segment is a major adverse complication. Platelet aggregation has a key role in stent thrombosis. We investigated whether a polymorphism of platelet glycoprotein IIIa gene (PIA2) is associated with an increased risk of coronary stent thrombosis. METHODS: 318 consecutive patients were followed up for 30 days after coronary stent insertion. The primary endpoints were death, myocardial infarction, stent-vessel occlusion, and coronary artery bypass surgery. Gel electrophoresis of PCR products was used to identify the PIA1 and PIA2 alleles. The relative risk of stent occlusion was calculated from the odds ratio on logistic regression analysis. FINDINGS: 63 (19.8%) of patients had the PIA2 allele and 255 (80.2%) were homozygous for PIA1. Baseline clinical, angiographic, and procedural features did not differ between the groups with and without the PIA2 allele. Occlusion of the stent vessel occurred in five (1.9%) patients homozygous for PIA1 and six (9.5%) patients with PIA2 allele (odds ratio 5.26 [95% CI 1.55-17.85]). On multivariate regression analysis PIA1/A2 genotype was the only significant independent predictor of stent thrombosis. INTERPRETATION:Patients with the pIA2 allele have an increased risk of coronary stent thrombosis, which may warrant antiplatelet therapy with glycoprotein-IIb/IIIa inhibitors, although bleeding complications may also increase.
Authors: Blanca Elsa Rivera-García; Juan Carlos Esparza-García; Jose Luis Aceves-Chimal; Alfredo Leaños-Miranda; Abraham Majluf-Cruz; Irma Isordia-Salas Journal: Mol Cell Biochem Date: 2013-09-05 Impact factor: 3.396
Authors: Young Joon Hong; Myung Ho Jeong; Yun Ha Choi; Eun Hye Ma; Jum Suk Ko; Min Goo Lee; Keun Ho Park; Doo Sun Sim; Nam Sik Yoon; Hyun Ju Youn; Kye Hun Kim; Hyung Wook Park; Ju Han Kim; Youngkeun Ahn; Jeong Gwan Cho; Jong Chun Park; Jung Chaee Kang Journal: Korean J Intern Med Date: 2010-11-27 Impact factor: 3.165
Authors: E I Levy; R Mehta; R Gupta; R A Hanel; A J Chamczuk; D Fiorella; H H Woo; F C Albuquerque; T G Jovin; M B Horowitz; L N Hopkins Journal: AJNR Am J Neuroradiol Date: 2007-05 Impact factor: 3.825
Authors: Joshua W Knowles; Huijan Wang; Haruka Itakura; Audrey Southwick; Richard M Myers; Carlos Iribarren; Stephen P Fortmann; Alan S Go; Thomas Quertermous; Mark A Hlatky Journal: Am Heart J Date: 2007-12 Impact factor: 4.749