糖蛋白IIIa的A1/A2多态性和与冠状动脉导管干预程序风险过高的关联:一个病例对照研究
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
概括
糖蛋白Illa的A1/A2多态性不会增加冠状动脉血管塑造,切除或支架后不良事件的风险. 这种遗传因素似乎不是这些心血管手术的重要风险因素.
科学领域:
- 心血管遗传学 心血管遗传学
- 干预心脏病学 干预心脏病学
- 药物基因组学 药物基因组学
背景情况:
- 糖蛋白Illa的A1/A2 (Leu33Pro) 多态已经与五倍增加的支架血栓形成风险有关.
- 这种多形态与其他冠状动脉干预相关风险之间的关联仍然不清楚.
研究的目的:
- 研究A1/A2多态的作用,作为在接受各种冠状动脉干预的患者中潜在的风险因素.
- 确定A1/A2多态是否与冠状动脉血管塑性,定向冠状动脉切除术和支架的程序风险增加有关.
主要方法:
- 在1000名冠状动脉疾病患者和1000名匹配对照中A1/A2多态的基因定型.
- 在653名接受干预的患者中,对30天复合终点 (目标血管再血管,心肌梗塞,死亡) 的评估.
主要成果:
- 没有证据表明A2等位基因与所有干预措施中的过度程序风险有关 (RR 1.36,p=0.37).
- 亚组分析显示,冠状动脉血管造形术,定向冠状动脉切除术或支架的风险没有增加.
- 在包括急性冠状动脉综合征或早期疾病表现在内的子组中,异构菌 (A1/A2) 和同构菌 (A2/A2) 均没有过度代表.
结论:
- A1/A2多态性并不是30天不良事件导致冠状动脉血管塑造,定向冠状动脉切除术或支架的重大风险因素.
- 这种遗传多态性似乎没有影响冠状动脉疾病 (动脉新生) 的发展.
相关概念视频
Aortic Regurgitation III: Medical Management
Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
Coronary Artery Disease II: Pathophysiology
Coronary Artery Disease (CAD) originates from a series of events that impair the function of coronary arteries, the blood vessels responsible for delivering oxygen-rich blood to the heart muscle. The pathophysiology of CAD is closely linked to atherosclerosis, a chronic inflammatory and lipid-driven condition affecting the vascular endothelium.1. Endothelial DamageThe process begins with damage to the vascular endothelium, which serves as a protective barrier between the blood and the vessel...
Acute Coronary Syndrome III: Diagnostic Studies
Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
Atherosclerosis III: Management
Management of atherosclerosis involves an integrated strategy encompassing pharmacological treatment, surgical interventions, lifestyle changes, and nutrition therapy to address the multifactorial nature of the disease.Pharmacological TherapyA cornerstone of atherosclerosis management is the use of pharmacological agents. Statins, such as atorvastatin, are pivotal in inhibiting HMG-CoA reductase, an enzyme that catalyzes an initial step in cholesterol synthesis in the liver. This reduction in...
Type I Diabetes II: Pathophysiology
Type 1 diabetes mellitus arises from an immune-mediated destruction of pancreatic β-cells, resulting in an absolute deficiency of insulin. This process develops in genetically susceptible individuals when autoimmunity, environmental exposures, and immunologic dysregulation converge to trigger a targeted attack on the insulin-producing cells of the pancreas. The β-cells are located within the islets of Langerhans and are essential for regulating blood glucose by facilitating cellular uptake of...
Type II Diabetes II: Pathophysiology
PathophysiologyType 2 diabetes mellitus (T2DM ) is a chronic metabolic disorder characterized by insulin resistance and progressive pancreatic β-cell dysfunction, leading to impaired glucose homeostasis. It results from interactions among genetic predisposition, environmental factors, and metabolic stressors, such as overnutrition and a sedentary lifestyle.Insulin Resistance and Glucose DysregulationEarly T2DM involves insulin resistance in skeletal muscle, adipose tissue, and the liver.

