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Polimorfismo A1/A2 de la glicoproteína IIIa y asociación con un exceso de riesgo procedimental para las
M Laule1, I Cascorbi, V Stangl
1Medizinische Klinik mit Schwerpunkt Kardiologie, Angiologie und Pneumologie, Humboldt-Universität zu Berlin, Germany.
Lancet (London, England)
|March 12, 1999
Resumen
El polimorfismo A1/A2 de la glicoproteína Illa no aumenta el riesgo de eventos adversos después de la angioplastia coronaria, aterectomía o stenting. Este factor genético no parece ser un factor de riesgo significativo para estos procedimientos cardiovasculares.
Área de la Ciencia:
- Genética cardiovascular Genética cardiovascular Genética cardiovascular Genética cardiovascular Genética cardiovascular
- Cardiología Intervencionista Cardiología intervencionista.
- La farmacogenómica es la farmacogenómica.
Sus antecedentes:
- El polimorfismo A1/A2 (Leu33Pro) de la glicoproteína Illa se ha relacionado con un aumento de cinco veces en el riesgo de trombosis de stent.
- La asociación entre este polimorfismo y los riesgos asociados con otras intervenciones coronarias sigue sin estar clara.
Objetivo del estudio:
- Investigar el papel del polimorfismo A1/A2 como un factor de riesgo potencial en pacientes sometidos a diversas intervenciones coronarias.
- Determinar si el polimorfismo A1/A2 está asociado con un mayor riesgo de procedimiento en angioplastia coronaria, aterectomía coronaria direccional y colocación de stent.
Principales métodos:
- Genotipización del polimorfismo A1/A2 en 1000 pacientes con enfermedad arterial coronaria y 1000 controles emparejados.
- Evaluación de un punto final compuesto de 30 días (revascularización del vaso objetivo, infarto de miocardio, muerte) en 653 pacientes que se sometieron a intervenciones.
Principales resultados:
- No se encontró evidencia de que el alelo A2 esté asociado con un exceso de riesgo procedimental en todas las intervenciones (RR 1.36, p=0.37).
- Los análisis de subgrupos no mostraron un aumento en el riesgo de angioplastia coronaria, aterectomía coronaria direccional o stenting.
- Ni los heterocigotos (A1/A2) ni los homocigotos (A2/A2) estaban sobrerrepresentados en los subgrupos que incluyen síndromes coronarios agudos o manifestación temprana de la enfermedad.
Conclusiones:
- El polimorfismo A1/A2 no es un factor de riesgo significativo para eventos adversos de 30 días que compliquen la angioplastia coronaria, la aterectomía coronaria direccional o la colocación de stents.
- Este polimorfismo genético no parece influir en el desarrollo de la enfermedad de las arterias coronarias (aterogénesis).
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