グリコプロテインIIIaのA1/A2ポリモルフィズムと冠動脈カテーテル介入の過剰な処置リスクとの関連:症例対照研究
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
まとめ
グリコプロテインIllaのA1/A2ポリモルフィズムにより,冠動脈血管新生手術,アテレクトミー,ステント設置後の有害事象のリスクは増加しません. この遺伝的要因は,これらの心血管疾患の手続きの重要なリスク要因ではないようです.
科学分野:
- 心血管の遺伝学について
- 介入性心臓病学 介入性心臓病学
- ファルマコゲノミクスとは
背景:
- グリコタンパク質イラのA1/A2 (Leu33Pro) ポリモルフィズムは,ステント血栓形成のリスク5倍増加と関連しています.
- このポリモルフィズムと他の冠動脈手術に関連するリスクとの関連は不明である.
研究 の 目的:
- A1/A2ポリモルフィズムが様々な冠動脈手術を受ける患者の潜在的なリスク因子としての役割を調査する.
- A1/A2ポリモルフィズムが冠動脈血管新生手術,定向冠動脈切除術,ステント設置における処置リスクの増加と関連しているかどうかを判断する.
主な方法:
- 1000人の冠動脈疾患患者と1000人の対照群でA1/A2ポリモルフィズムをゲノタイプ化.
- 介入を受けた653人の患者で30日間の複合エンドポイント (標的血管再血管化,心筋梗塞,死亡) の評価.
主要な成果:
- すべての介入において,A2アレルが過剰な手続きリスクと関連している証拠は見つかりませんでした (RR 1.36,p=0.37).
- サブグループ分析では,冠動脈血管形成術,定向冠動脈切除術,またはステントのリスクの増加は示されなかった.
- ヘテロジゴト (A1/A2) やホモジゴト (A2/A2) は,急性冠動脈症候群や早期発症を含むサブグループで過剰に表現されませんでした.
結論:
- A1/A2ポリモルフィズムは,冠動脈血管新生手術,方向冠動脈アテレクトミー,またはステントを合併させる30日間の有害事象の有意なリスク要因ではありません.
- この遺伝子ポリモルフィズムが冠動脈疾患 (アテロゲネシス) の発症に影響を与えているようには見えない.
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