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Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
10:28

Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function

Published on: March 15, 2022

Reduced procedural risk for coronary catheter interventions in carriers of the coagulation factor VII-Gln353 gene

P M Mrozikiewicz1, I Cascorbi, S Ziemer

  • 1Institute of Clinical Pharmacology, Charité University Medical Center, Humboldt University of Berlin, Germany.

Journal of the American College of Cardiology
|November 18, 2000
PubMed

Insights

The Gln353 allele of coagulation factor VII (FVII) significantly reduces adverse events after coronary interventions like PTCA and stenting. This finding suggests FVII genotype may guide treatment decisions for patients undergoing these procedures.

Area of Science:

  • Cardiovascular Medicine
  • Genetics
  • Interventional Cardiology

Background:

  • The Arg353Gln polymorphism in coagulation factor VII (FVII) influences FVII activity.
  • The Gln353 allele may offer protection against thrombus formation during catheter-based cardiovascular interventions.

Purpose of the Study:

  • To evaluate the coagulation factor VII (FVII) Arg353Gln polymorphism as a predictor of complications after percutaneous transluminal coronary angioplasty (PTCA), directional coronary atherectomy (DCA), and stenting.
  • To assess the association between FVII genotype and adverse events in patients undergoing coronary interventions.

Main Methods:

  • A cohort of 666 patients with coronary artery disease undergoing PTCA, DCA, or stenting were followed for 30 days.
  • A composite endpoint including target vessel revascularization, myocardial infarction, and death was recorded.
  • FVII Arg353Gln polymorphism was determined using PCR/RFLP analysis.

Main Results:

  • Carriers of the Gln353 allele exhibited significantly lower FVII activity (FVIIc and FVIIa) compared to Arg353/Arg353 homozygotes.
  • The incidence of the composite endpoint was 2.5% in Gln353 allele carriers versus 7.7% in Arg353/Arg353 homozygotes (p = 0.013).
  • Carriage of the Gln353 allele was associated with a 72% risk reduction in adverse events (relative risk: 0.28; p = 0.02).

Conclusions:

  • The FVII Gln353 allele is linked to a significant reduction in adverse events following coronary catheter interventions.
  • FVII genotype may be a crucial factor in assessing and dosing FVIIai (active site-blocked activated FVII) medication.
  • These findings highlight the importance of considering genetic variations in FVII for personalized cardiovascular treatment strategies.
Abstract

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