Heme oxygenase-1 gene promoter microsatellite polymorphism is associated with restenosis after percutaneous transluminal angioplasty

M Exner, M Schillinger, E Minar… - Journal of …, 2001 - journals.sagepub.com
M Exner, M Schillinger, E Minar, W Mlekusch, G Schlerka, M Haumer, C Mannhalter…
Journal of endovascular therapy, 2001journals.sagepub.com
Purpose: To determine if an association exists between postdilation restenosis and heme
oxygenase-1 (HO-1), which is induced by balloon injury and inhibits neointimal formation
through the action of endogenous carbon monoxide. A dinucleotide repeat in the promoter
region of the HO-1 gene shows a length polymorphism that modulates the level of gene
transcription. Methods: This cohort study included 96 consecutive patients (64 men; median
age 69 years, interquartile range 60–75) who underwent successful balloon dilation in the …
Purpose
To determine if an association exists between postdilation restenosis and heme oxygenase-1 (HO-1), which is induced by balloon injury and inhibits neointimal formation through the action of endogenous carbon monoxide. A dinucleotide repeat in the promoter region of the HO-1 gene shows a length polymorphism that modulates the level of gene transcription.
Methods
This cohort study included 96 consecutive patients (64 men; median age 69 years, interquartile range 60–75) who underwent successful balloon dilation in the femoropopliteal segment. Six-month patency was evaluated using oscillography, ankle-brachial index, and duplex sonography. The association of patency and the length of (GT) repeats in the HO-1 gene promoter was assessed in univariate and multivariate analyses.
Results
Restenosis was found in 23 (24%) patients within the first 6 months. Patients with short (<25 GT) dinucleotide repeats in the HO-1 gene promoter on either allele had restenosis significantly less often than patients with longer (≥25 GT) dinucleotide repeats (p = 0.01). Multivariate analysis revealed a significantly reduced risk for restenosis in these patients compared to patients without the short allele (odds ratio 0.2, 95% CI 0.06 to 0.70, p = 0.007).
Conclusions
Genetic risk factors for restenosis after percutaneous transluminal angioplasty have not been investigated. In this patient population, short repeat alleles of the heme oxygenase-1 gene promoter polymorphism were associated with reduced postdilation restenosis at 6 months. Upregulation of HO-1 may be an important protective factor after balloon angioplasty by inhibition of vascular smooth muscle cell proliferation.
Sage Journals