Key result
ACE I/D gene polymorphism shows no association with in-stent restenosis.
Why the study?
The study aimed to examine the role of ACE (I/D) gene polymorphisms according to stent types (Biomime, Supraflex, Xience) in patients who underwent angioplasty.
Does ACE (I/D) gene polymorphism increase in-stent restenosis in patients who underwent angioplasty with drug-eluting stents?
Case-Control (n=121)
No
Does ACE (I/D) gene polymorphism increase in-stent restenosis in patients who underwent angioplasty with drug-eluting stents?
ACE (I/D) gene polymorphism is not significantly associated with in-stent restenosis in patients receiving Biomime, Supraflex, or Xience stents, whereas clopidogrel use appears to have an inhibitory effect on the recurrence of stenosis.
ACE (I/D) polymorphism does not support ISR risk stratification after DES; leaves open other genetic or clinical predictors.
Introduction: Angiotensin Converting Enzyme or ACE is an exopeptidase that causes the conversion of angiotensin I to angiotensin II, vasoconstriction, and aldosterone secretion. ACE gene polymorphism (I/D) causes more enzyme activity and increases the risk of coronary artery disease or CAD. Aims: To examine the role of ACE (I/D) Gene Polymorphisms by Stent Types (Biomime, Supraflex, Xience) has been investigated in patients who underwent angioplasty in this study. Material & Methods: Patients in the in-stent restenosis group (ISR + ) (N=53) and patients non-ISR group (ISR - ) (N=68) have been enrolled in this study based on follow-up angiography > 1 year after PCI. Frequencies of allele and genotypes of the ACE (I/D) variant were determined using polymerase chain reaction (PCR). Results: The genotypes and allele frequencies were not significantly different between the studied populations (p-Values > 0.05). However, there was a significant difference between people with a history of Clopidogrel use in the ISR- and ISR+ groups observed (p-Values > 0.005). Conclusion: In the present study, there was no statistically significant relationship between ACE (I/D) gene polymorphism and the incidence of restenosis in patients who underwent repeat angiography. However, the ratio of frequency percentage of alleles to each other in terms of frequency shows the highest to lowest alleles I/D, D/D, and I/I in both groups. In the comparison of drugs used among patients, the drug Clopidogrel (Plavix) is discussed in the incidence of restenosis, in this study, the results showed that the number of patients who received Clopidogrel in the ISR+ group was significantly less than the ISR- group. This issue can indicate the inhibitory effect of Clopidogrel in the recurrence of stenosis.
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Klashami et al. (2023) conducted a case-control in In-Stent Restenosis (n=121). ACE (I/D) gene polymorphism vs. Non-ISR group (ISR-) was evaluated on Incidence of in-stent restenosis based on ACE (I/D) genotype and allele frequencies (p=>0.05). ACE (I/D) gene polymorphism showed no statistically significant relationship with the incidence of in-stent restenosis in patients who underwent repeat angiography.
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