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Revista chilena de cardiología

On-line version ISSN 0718-8560

Abstract

BOBADILLA, Braulio et al. Polymorphisms of Tumor Necrosis Factor gen: are they associated to Stent Restenosis after Coronary Angioplasty?. Rev Chil Cardiol [online]. 2016, vol.35, n.2, pp.91-98. ISSN 0718-8560.  http://dx.doi.org/10.4067/S0718-85602016000200001.

Multiple factors have been associated to the development of stent restenosis after coronary angioplasty (PCA). including clinical, angiographic, genetic and epigenetic factors. The inflammatory response is genetically determined and it may be the most important factor. Tumor necrosis factor a (TNFα) is a potent mediator of this response at the endothelial wall.  Aim: To determine the association between TNFα genetic polymorphisms and stent restenosis.         Methods: A case-control study was performed in patients submitted to PTCA with stent implantation(-bare metal or drug eluting stent) at least 6 months prior to the study. Cases were defined by the presence of >50% intra stent stenosis. PCR was used for type classification of polymorphisms rs361525 (-238G/A) y rs1799964 (-1031 T/C) of the TNFα gene.  Results: 82 cases and 102 controls were included. No differences were observed in clinical and demographic variables: age (63.7 ± 10.5 vs. 65.4 ± 9.6 years, p=0.24, for cases and controls, respectively), male gender (75 vs. 69%, p=0.5), BMI (28.5 ± 3.6 vs. 28 ± 3.8 Kg/m2, p=0.78) and active smoking (79 vs. 77%, p=0.7). In contrast, Diabetes was more frequent in cases than in controls (43.2 vs. 26.5%, p=0.03). There was no difference in the relative frequency of mutations of the rs361525 polymorphism (Allele A, 0.06 vs 0.08, p=0.37 for cases and controls, respectively) nor for variant rs1799964 (0.2 in both cases and controls). Non significant associations were confirmed by Odd ratios with 0 included in the 95% confidence interval.  Conclusion: No association of genetic polymorphisms of TNFa and stent restenosis was found, which suggests that clinical factors my be more important for the development of post PTCA stent restenosis.

Keywords : Restenosis; Angioplasty; coronary; genetic polymorphisms; tumor necrosis factor α.

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