Key result
CMA-1905 G allele homozygosity is linked to substantially greater bypass degeneration versus the AA genotype.
Why the study?
The impact of genetic polymorphisms of the renin-angiotensin-aldosterone system on coronary bypass graft degeneration was unknown.
Are genetic polymorphisms of the renin-angiotensin-aldosterone system associated with bypass graft degeneration in symptomatic patients after CABG?
Observational (n=101)
Are genetic polymorphisms of the renin-angiotensin-aldosterone system associated with bypass graft degeneration in symptomatic patients after CABG?
The CMA allele G is identified as a potential genetic risk factor for atherosclerosis in venous coronary artery bypass grafts.
CMA-1905 GG may mark higher risk of bypass degeneration; extends RAAS polymorphism research but should not yet alter practice.
BACKGROUND: Angiotensin II is known to stimulate proliferation of fibroblasts and smooth muscle cells and enhance the atherosclerotic process in native coronary arteries. The impact of genetic polymorphisms of the renin-angiotensin-aldosterone system on coronary bypass graft degeneration is unknown. METHODS: We examined polymorphisms of four genes (AGTR1, CYP11B2, ACE, CMA) in 101 patients who had follow-up coronary angiography due to symptoms 88 +/- 52 months after coronary artery bypass graft surgery. Bypass degeneration was determined with quantitative coronary angiography and an adjusted Gensini score. RESULTS: Homozygosity for the G allele of the CMA-1905 polymorphism was associated with a higher degree of bypass degeneration (Bypass Gensini score CMA AA 21.4 +/- 39; AG 24.2 +/- 39.8; GG 27.8 +/- 42.3; NS-time adjusted Gensini bypass scores CMA AA 0.25 +/- 0.68; AG 0.57 +/- 1.82; GG 3.25 +/- 13.2; P = 0.005). No association could be detected for the AGTR1, CYP11B2 or ACE polymorphism. CONCLUSION: The CMA allele G is a genetic risk factor for atherosclerosis in venous coronary artery bypass grafts. Its importance has to be shown in further studies. Other polymorphisms of the renin-angiotensin-aldosterone system do not seem to play a role in bypass degeneration.
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Ortlepp et al. (2001) conducted an observational in Atherosclerosis in venous coronary artery bypass grafts (n=101). CMA-1905 polymorphism (G allele) vs. CMA AA or AG genotypes was evaluated on Bypass degeneration determined with quantitative coronary angiography and an adjusted Gensini score (p=0.005). Homozygosity for the G allele of the CMA-1905 polymorphism was associated with a higher degree of bypass degeneration (time-adjusted Gensini score 3.25 vs 0.25 for AA; P=0.005).
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