New Opportunities for Determining the Terms of Carrying out the Control Coronarangiography after Percutaneous Coronary Intervention

D. Brusentsov, P. Shesternya
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Abstract

Background. Coronary heart disease is the leading cause of death in the Russian Federation, causing social and economic damage to the state. Previously published studies showed the association of rs1800470 polymorphism of the gene of the transforming growth factor-β1 (TGF-β1) with the risk of developing coronary artery disease due to more severe atherosclerotic lesions of the coronary arteries. Aim of the research. To study the association of single-nucleotide polymorphism rs1800470 of the TGF-β1 gene with the rate of progression of atherosclerotic coronary artery lesion. Material and methods. The study included 89 men with myocardial infarction, a Caucasian race under the age of 65 years (51 ± 7.9). Genomic DNA was isolated from venous blood by the phenol-chloroform method. The rs1800470 polymorphism of the TGF-β1 gene was tested using real-time polymerase chain reaction (PCR) (TaqMan probes, AB 7900HT). Assessment of the severity of coronary lesion was carried out initially according to the standard polyprojection coronary angiography protocol with the Gensini score calculated, as well as in dynamics after 40.7 ± 29.7 months (from 5 to 103 months). Results. Carrier of the rs1800470 allele A of the TGF-β1 gene is an independent risk factor for coronary heart disease and is associated with a more aggressive course of coronary atherosclerosis in men: a 20 % worsening of the Gensini score was observed after 7 months (p = 0.013), and by 30 % after 5 months (p = 0.003) from the initial coronary angiography. In addition, the homozygous genotype AA rs1800470 of the TGF-β1 gene is associated with the development of late stent restenoses in this group of patients after 12 months of observation (p = 0.002). Conclusion. Identification of carriers of the rs1800470 allele A of the TGF-β1 gene can help identify patients at risk for more rapid progression of coronary artery atherosclerosis in order to conduct angiographic control in the early period – 6 months from the initial percutaneous coronary intervention.
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确定经皮冠状动脉介入治疗后对照冠状动脉造影条件的新机遇
背景。冠心病是俄罗斯联邦的主要死亡原因,对国家造成社会和经济损害。先前发表的研究表明,转化生长因子-β1 (TGF-β1)基因rs1800470多态性与冠状动脉粥样硬化病变加重导致冠状动脉疾病的发生风险相关。研究的目的。研究TGF-β1基因单核苷酸多态性rs1800470与动脉粥样硬化性冠状动脉病变进展速度的关系。材料和方法。该研究纳入89例65岁(51±7.9)岁以下的心肌梗死男性白种人。采用苯酚-氯仿法从静脉血中分离基因组DNA。采用实时聚合酶链反应(PCR) (TaqMan探针,AB 7900HT)检测TGF-β1基因rs1800470多态性。最初根据标准多投影冠状动脉造影方案进行冠状动脉病变严重程度评估,计算Gensini评分,并在40.7±29.7个月(从5到103个月)后进行动态评估。结果。TGF-β1基因rs1800470等位基因A的携带者是冠心病的独立危险因素,与男性冠状动脉粥样硬化的侵袭性病程相关:7个月后观察到Gensini评分恶化20% (p = 0.013), 5个月后恶化30% (p = 0.003)从最初的冠状动脉造影。另外,TGF-β1基因AA rs1800470纯合子基因型与本组患者观察12个月后发生晚期支架再狭窄相关(p = 0.002)。结论。识别TGF-β1基因rs1800470等位基因A的携带者,有助于识别冠状动脉粥样硬化进展更快的高危患者,以便在早期-经皮冠状动脉介入治疗后6个月进行血管造影控制。
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