מתוך medicontext.co.il
WESTPORT, CT (Reuters Health) – Homozygous carriers of the deletion angiotensin-converting enzyme (ACE) gene who undergo stenting for revascularization are at increased risk of in-stent restenosis if they receive ACE inhibitor therapy, Danish and Dutch researchers report in the November 1st issue of the Journal of the American College of Cardiology.
Dr. Erik Jorgensen of Rigshospitalet, Copenhagen, and colleagues performed ACE genotyping in 369 patients who were undergoing stent implantation for coronary artery disease. The investigators determined whether the patients were homozygous for the ACE deletion allele, heterozygous for the deletion/insertion allele, or homozygous for the ACE insertion allele.
The investigators found no differences between the three genotypes in minimal lumen diameter, with stenoses in the range of 25% to 27%. The rate of restenosis ranged from 11% to 16%, not statistically different in the three groups.
However, unexpectedly, in the group homozygous for the ACE deletion allele, the rate of in-stent restenosis was 40% in those who received ACE inhibition therapy after the procedure compared with 12% in those who did not. Overall, about 15% of patients in the study received ACE inhibition therapy.
The investigators note that "in general, there is no reason to test for this polymorphism when planning percutaneous coronary interventions with stent implantation." But the fact that ACE inhibitor therapy increased the rate of in-stent restenosis warrants further study, they conclude.
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