Title of article :
Reduced procedural risk for coronary catheter interventions in carriers of the coagulation factor VII-Gln353 gene  
Author/Authors :
Przemyslaw M. Mrozikiewicz، نويسنده , , Ingolf Cascorbi، نويسنده , , Sabine Ziemer، نويسنده , , Michael Laule، نويسنده , , Christian Meisel، نويسنده , , Verena Stangl، نويسنده , , Wolfgang Rutsch، نويسنده , , Klaus Wernecke، نويسنده , , Gert Baumann، نويسنده , , Ivar Roots، نويسنده , , Karl Stangl، نويسنده ,
Issue Information :
روزنامه با شماره پیاپی سال 2000
Pages :
6
From page :
1520
To page :
1525
Abstract :
OBJECTIVES We have focused on the role of coagulation factor VII (FVII) Arg353Gln polymorphism as a risk predictor of complications following percutaneous transluminal coronary angioplasty (PTCA), directional coronary atherectomy (DCA), and stenting. BACKGROUND The FVII Arg353Gln mutation decreases FVII activity, and presence of the Gln353 allele could be protective against thrombus formation during catheter interventions. METHODS A total of 666 consecutive patients with coronary artery disease who had undergone PTCA (n = 280), DCA (n = 104), or stenting (n = 282) were followed up for a 30-day composite end point, which included need for target vessel revascularization, myocardial infarction, and death. The Arg353Gln polymorphism of FVII was determined by PCR/RFLP assay. RESULTS Carriers of the Gln353 allele had significantly lower levels of total FVII activity (FVIIc, −20.7%, p < 0.001) and of activated circulating FVII (FVIIa, −32.7%, P = 0.03) compared with Arg353/Arg353. The composite end point occurred in 43 patients: 4 were heterozygous Arg353/Gln353, and 39 were homozygous Arg353/Arg353. The incidence of the composite end point was 2.5% in carriers of the Gln353 allele and 7.7% in Arg353/Arg353 homozygotes (p = 0.013). This corresponds to a 72% risk reduction in carriers of the Gln353 allele (relative risk: 0.28; 95% confidence interval: 0.09–0.81; P = 0.02). CONCLUSIONS The Gln353 allele of FVII is associated with substantial risk reduction in adverse events that complicate coronary catheter interventions. With the perspective of active site-blocked activated FVII (FVIIai) as conjunctive medication, the results suggest that the FVII genotype should be taken into due consideration in assessment of FVIIai medication and of its dosage.
Keywords :
factor VII , Thrombolysis In Myocardial Infarction , activated FVII , target-vessel revascularization , FVIIai , active site-blocked activated FVII , total FVII activity , FVIIc , FVIIa , TVR , fVII , TIMI , MI , myocardial infarction , coronary artery disease , percutaneous transluminal coronary angioplasty , CAD , PTCA , DCA , TF , directional coronary atherectomy , tissue factor , NT , nucleotide
Journal title :
JACC (Journal of the American College of Cardiology)
Serial Year :
2000
Journal title :
JACC (Journal of the American College of Cardiology)
Record number :
596171
Link To Document :
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