Candidate Gene of NOS3, MMP3, AGT, and AGT1R and Pathway Analyses for Platelet Reactivity and Clinical Outcomes of Repeat Revascularization After First PCI in Chinese Patients

2021 ◽  
Author(s):  
Shuang Zhou ◽  
Zhe Wang ◽  
Zhiyan Liu ◽  
Guangyan Mu ◽  
Qiufen Xie ◽  
...  
Keyword(s):  
Candidate Gene ◽  
Clinical Outcomes ◽  
Chinese Patients ◽  
Test Results ◽  
Repeat Revascularization ◽  
Aggregation Rate ◽  
Stent Restenosis ◽  
Increased Risk ◽  
Genetic Test Results ◽  
In Stent Restenosis

Abstract Purpose Major disadvantages of the percutaneous coronary intervention (PCI) are the high occurrence of repeat revascularization due to restenosis and disease progression. The current study aimed to identify indicators that can predict the risk of repeat revascularization. Methods A total of 143 patients who underwent PCI and had genetic test results were enrolled. We retrospectively reviewed their medical records after the first PCI. P2Y12 reaction units (PRU) test results were obtained by VerifyNow; 372 SNPs of NOS3, MMP3, AGT, and AGT1R gene and 380 genes related to platelet activation-related processes and clopidogrel activity were selected for analysis. Repeat revascularization and in-stent restenosis (ISR) were used as clinical outcomes, and PRU and ADP aggregation rates were used as platelet function outcomes in analysis. Results After the first PCI, the incidence of repeat revascularization at 18, 30, and 42 months was 14.1% (20/142), 17.5% (24/137), and 39.7% (31/78), respectively. In the candidate gene analysis, Rs 78830 (NOS3) was associated with both ADP aggregation rate and 18- and 30-month ISR, and rs 62275847 (AGTR1) was associated with both ADP aggregation rate and 30-month ISR. In the pathway, gene-set analysis, the linkage rs471683 and rs7785386 of GNAI1|GNAT3 were associated with PRU and ADP aggregation rate, 18-months and 30-months ISR, and repeat revascularization within 30 months. Rs1715389 of GNAI1|GNAT3 were associated with both PRU and ADP aggregation rate, 18-months and 30-months ISR, and repeat revascularization within 30 months. Rs7313458 of ITPR2 were associated with PRU and ADP aggregation rate, 18-months and 30-months ISR, and repeat revascularization within 18 months. Conclusions The genetic polymorphisms of rs78830(NOS3), rs62275874 (AGTR1), linkage rs471683 and rs7785386 (GNAI1|GNAT3), rs1715389(GNAI1|GNAT3), and rs7313458 (ITPR2) may lead to an increased risk of in-stent restenosis and revascularization after the first PCI in Chinese patients by affecting the efficacy of clopidogrel. The above six SNP may be used as potential genetic biomarkers for high risk of in-stent restenosis and revascularization after the first PCI in Chinese patients.

scholarly journals Intermittent concurrent use of clopidogrel and proton pump inhibitors did not increase risk of adverse clinical outcomes in Chinese patients with coronary artery disease

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Wanbing He ◽  
Xiaorong Shu ◽  
Enyi Zhu ◽  
Bingqing Deng ◽  
Yongqing Lin ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Cox Regression ◽  
Asian Population ◽  
Chinese Patients ◽  
Clinical Event ◽  
Cardiac Events ◽  
Concurrent Use ◽  
Increased Risk

Abstract Background Proton pump inhibitors (PPIs) are frequently prescribed to patients with coronary heart disease (CHD) under antiplatelet therapy to prevent gastrointestinal (GI) bleeding. However, its clinical impact is still under debate, especially in Asian population. This study was undertaken to explore the effects of concurrent use of clopidogrel and PPIs on the clinical outcomes in Chinese patients with CHD in secondary prevention. Methods A single-center retrospective study was conducted in 638 patients with CHD on consecutive clopidogrel therapy for at least 1 year. After 18-month follow-up, adverse clinical events were collected. Cox regression was used to calculate hazard ratios (HR) and 95% confidence interval (CI) for the effect of PPI use on the outcomes. A total of 638 patients were recruited from 2014 to 2015 in this study, among whom 201 were sustained PPI users, 188 were intermittent PPI users and the remaining 249 were non-PPI users. Results Compared with sustained PPI users, intermittent use of PPIs was associated with a lower risk of stroke, major adverse cardiac events (MACE) and net adverse clinical event (NACE) (stroke: adjusted HR: 0.109, 95% CI 0.014–0.878, p = 0.037; MACE: adjusted HR: 0.293, 95% CI 0.119–0.722; p = 0.008; NACE: adjusted HR: 0.357, 95% CI 0.162–0.786, p = 0.011). Subgroup analysis further revealed the benefit of intermittent PPI use was significant in male CHD patients over 60 years old, with hypertension or chronic kidney disease, and undergoing percutaneous coronary intervention during hospitalization. Conclusion The current findings suggest that the intermittent concurrent use of PPIs and clopidogrel is not associated with an increased risk of 18-month adverse clinical outcomes, and intermittent use of PPIs is associated with a lower rate of MACE and NACE.

scholarly journals Clinical outcomes in patients treated for coronary in-stent restenosis with drug-eluting balloons: Impact of high platelet reactivity

PLoS ONE ◽  
2017 ◽  
Vol 12 (12) ◽  
pp. e0188493 ◽  
Author(s):  
Adrienn Tornyos ◽  
Dániel Aradi ◽  
Iván G. Horváth ◽  
Attila Kónyi ◽  
Balázs Magyari ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Platelet Reactivity ◽  
High Platelet Reactivity ◽  
Stent Restenosis ◽  
Drug Eluting ◽  
In Stent Restenosis

Incidence, procedural management, and clinical outcomes of coronary in-stent restenosis: Insights from the National VA CART Program

2017 ◽  
Vol 91 (3) ◽  
pp. 425-433 ◽  
Author(s):  
Stephen W. Waldo ◽  
Colin I. O'Donnell ◽  
Andrew Prouse ◽  
Mary E. Plomondon ◽  
Sunil V. Rao ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Stent Restenosis ◽  
In Stent Restenosis

scholarly journals IMPACT OF ANGIOGRAPHIC PATTERNS OF IN-STENT RESTENOSIS ON LONG-TERM CLINICAL OUTCOMES IN PATIENTS TREATED WITH COBALT-CHROMIUM EVEROLIMUS-ELUTING STENT

2020 ◽  
Vol 75 (11) ◽  
pp. 1368
Author(s):  
Takashi Hiromasa ◽  
Shoichi Kuramitsu ◽  
Seiichi Hiramori ◽  
Kyohei Yamaji ◽  
Takenori Domei ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Cobalt Chromium ◽  
Stent Restenosis ◽  
In Stent Restenosis

scholarly journals Health Care Monitoring and Treatment for Coronary Artery Diseases: Challenges and Issues

Sensors ◽  
2020 ◽  
Vol 20 (15) ◽  
pp. 4303
Author(s):  
Mokhalad Alghrairi ◽  
Nasri Sulaiman ◽  
Saad Mutashar
Keyword(s):  
Coronary Artery ◽  
Blood Clotting ◽  
Coronary Artery Diseases ◽  
Monitoring Technology ◽  
Stent Restenosis ◽  
Increased Risk ◽  
Cause Of Deaths ◽  
One Year ◽  
Health Care Monitoring ◽  
In Stent Restenosis

In-stent restenosis concerning the coronary artery refers to the blood clotting-caused re-narrowing of the blocked section of the artery, which is opened using a stent. The failure rate for stents is in the range of 10% to 15%, where they do not remain open, thereby leading to about 40% of the patients with stent implantations requiring repeat procedure within one year, despite increased risk factors and the administration of expensive medicines. Hence, today stent restenosis is a significant cause of deaths globally. Monitoring and treatment matter a lot when it comes to early diagnosis and treatment. A review of the present stent monitoring technology as well as the practical treatment for addressing stent restenosis was conducted. The problems and challenges associated with current stent monitoring technology were illustrated, along with its typical applications. Brief suggestions were given and the progress of stent implants was discussed. It was revealed that prime requisites are needed to achieve good quality implanted stent devices in terms of their size, reliability, etc. This review would positively prompt researchers to augment their efforts towards the expansion of healthcare systems. Lastly, the challenges and concerns associated with nurturing a healthcare system were deliberated with meaningful evaluations.

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