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Reduced procedural risk for coronary catheter interventions in carriers of the coagulation factor VII-Gln353 gene.
J Am Coll Cardiol. 2000 Nov 01; 36(5):1520-5.JACC

Abstract

OBJECTIVES

We have focused on the role of coagulation factor VII (FVII) Arg353Gln polymorphism as a risk predictor of complications following percutaneous transluminal coronary angioplasty (PTCA), directional coronary atherectomy (DCA), and stenting.

BACKGROUND

The FVII Arg353Gln mutation decreases FVII activity, and presence of the Gln353 allele could be protective against thrombus formation during catheter interventions.

METHODS

A total of 666 consecutive patients with coronary artery disease who had undergone PTCA (n = 280), DCA (n = 104), or stenting (n = 282) were followed up for a 30-day composite end point, which included need for target vessel revascularization, myocardial infarction, and death. The Arg353Gln polymorphism of FVII was determined by PCR/RFLP assay.

RESULTS

Carriers of the Gln353 allele had significantly lower levels of total FVII activity (FVIIc, -20.7%, p < 0.001) and of activated circulating FVII (FVIIa, -32.7%, p = 0.03) compared with Arg353/Arg353. The composite end point occurred in 43 patients: 4 were heterozygous Arg353/Gln353, and 39 were homozygous Arg353/Arg353. The incidence of the composite end point was 2.5% in carriers of the Gln353 allele and 7.7% in Arg353/Arg353 homozygotes (p = 0.013). This corresponds to a 72% risk reduction in carriers of the Gln353 allele (relative risk: 0.28; 95% confidence interval: 0.09-0.81; p = 0.02).

CONCLUSIONS

The Gln353 allele of FVII is associated with substantial risk reduction in adverse events that complicate coronary catheter interventions. With the perspective of active site-blocked activated FVII (FVIIai) as conjunctive medication, the results suggest that the FVII genotype should be taken into due consideration in assessment of FVIIai medication and of its dosage.

Authors+Show Affiliations

Institute of Clinical Pharmacology, Charité University Medical Center, Humboldt University of Berlin, Germany.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

11079652

Citation

Mrozikiewicz, P M., et al. "Reduced Procedural Risk for Coronary Catheter Interventions in Carriers of the Coagulation Factor VII-Gln353 Gene." Journal of the American College of Cardiology, vol. 36, no. 5, 2000, pp. 1520-5.
Mrozikiewicz PM, Cascorbi I, Ziemer S, et al. Reduced procedural risk for coronary catheter interventions in carriers of the coagulation factor VII-Gln353 gene. J Am Coll Cardiol. 2000;36(5):1520-5.
Mrozikiewicz, P. M., Cascorbi, I., Ziemer, S., Laule, M., Meisel, C., Stangl, V., Rutsch, W., Wernecke, K., Baumann, G., Roots, I., & Stangl, K. (2000). Reduced procedural risk for coronary catheter interventions in carriers of the coagulation factor VII-Gln353 gene. Journal of the American College of Cardiology, 36(5), 1520-5.
Mrozikiewicz PM, et al. Reduced Procedural Risk for Coronary Catheter Interventions in Carriers of the Coagulation Factor VII-Gln353 Gene. J Am Coll Cardiol. 2000 Nov 1;36(5):1520-5. PubMed PMID: 11079652.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Reduced procedural risk for coronary catheter interventions in carriers of the coagulation factor VII-Gln353 gene. AU - Mrozikiewicz,P M, AU - Cascorbi,I, AU - Ziemer,S, AU - Laule,M, AU - Meisel,C, AU - Stangl,V, AU - Rutsch,W, AU - Wernecke,K, AU - Baumann,G, AU - Roots,I, AU - Stangl,K, PY - 2000/11/18/pubmed PY - 2001/2/28/medline PY - 2000/11/18/entrez SP - 1520 EP - 5 JF - Journal of the American College of Cardiology JO - J Am Coll Cardiol VL - 36 IS - 5 N2 - OBJECTIVES: We have focused on the role of coagulation factor VII (FVII) Arg353Gln polymorphism as a risk predictor of complications following percutaneous transluminal coronary angioplasty (PTCA), directional coronary atherectomy (DCA), and stenting. BACKGROUND: The FVII Arg353Gln mutation decreases FVII activity, and presence of the Gln353 allele could be protective against thrombus formation during catheter interventions. METHODS: A total of 666 consecutive patients with coronary artery disease who had undergone PTCA (n = 280), DCA (n = 104), or stenting (n = 282) were followed up for a 30-day composite end point, which included need for target vessel revascularization, myocardial infarction, and death. The Arg353Gln polymorphism of FVII was determined by PCR/RFLP assay. RESULTS: Carriers of the Gln353 allele had significantly lower levels of total FVII activity (FVIIc, -20.7%, p < 0.001) and of activated circulating FVII (FVIIa, -32.7%, p = 0.03) compared with Arg353/Arg353. The composite end point occurred in 43 patients: 4 were heterozygous Arg353/Gln353, and 39 were homozygous Arg353/Arg353. The incidence of the composite end point was 2.5% in carriers of the Gln353 allele and 7.7% in Arg353/Arg353 homozygotes (p = 0.013). This corresponds to a 72% risk reduction in carriers of the Gln353 allele (relative risk: 0.28; 95% confidence interval: 0.09-0.81; p = 0.02). CONCLUSIONS: The Gln353 allele of FVII is associated with substantial risk reduction in adverse events that complicate coronary catheter interventions. With the perspective of active site-blocked activated FVII (FVIIai) as conjunctive medication, the results suggest that the FVII genotype should be taken into due consideration in assessment of FVIIai medication and of its dosage. SN - 0735-1097 UR - https://www.unboundmedicine.com/medline/citation/11079652/Reduced_procedural_risk_for_coronary_catheter_interventions_in_carriers_of_the_coagulation_factor_VII_Gln353_gene_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0735-1097(00)00925-6 DB - PRIME DP - Unbound Medicine ER -