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677TT polymorphism of methylenetetrahydrofolate reductase in combination with low serum vitamin B12 is associated with coronary in-stent restenosis.
Catheter Cardiovasc Interv. 2006 Mar; 67(3):349-55.CC

Abstract

BACKGROUND

Recent studies have shown that a common mutation (nucleotide 677 C-->T) in the methylenetetrahydrofolate reductase (MTHFR) gene may contribute to a mild rise in plasma homocysteine levels and increase the incidence of coronary artery disease. Therefore, this study was designed to further investigate whether the effects of MTHFR 677 C to T mutation, plasma homocysteine, serum vitamin B12, and folate can influence restenosis after successful coronary stenting.

METHODS AND RESULTS

We investigated 260 patients each with a lesion after successful coronary stent placement. All patients received a repeated angiography after 6 months, or earlier if clinically indicated. Angiographic in-stent restenosis (ISR) was defined as >or=50% diameter stenosis at follow-up. Genotyping for MTHFR was based on a polymerase chain reaction technique. Also fasting plasma homocysteine, vitamin B12, and folate levels were measured at the same time. The ISR rate was higher among the patients with the TT genotype than in those with the non-TT genotypes (64.0% versus 32.9%, P=0.002). There was no significant difference in plasma homocysteine levels among patients with the TT genotype and patients with the non-TT genotypes (15.9+/-7.6 versus 15.5+/-6.6 micromol/L, P=0.75). However, among the patients with the TT genotype, those with higher plasma homocysteine levels (>or=12 micromol/L) demonstrated a significantly higher ISR rate (75.0% versus 33.5%, P=0.001). Logistic regression analysis revealed that the combined presence of the MTHFR TT genotype and lower than average serum vitamin B12 (>or=550 pg/mL) resulted in the most significant difference in the risk of ISR (OR=3.57, CI=1.51-8.46, P=0.004; OR=2.36, CI=1.35-4.15, P=0.003).

CONCLUSIONS

MTHFR 677TT polymorphism and low serum vitamin B12 each individually increased the risk of coronary ISR. Furthermore, the combination of these parameters resulted in a greater increase in risk.

Authors+Show Affiliations

Division of Cardiology, Department of Medicine, LoTung Poh-Ai Hospital, Yilan County, Taiwan.No affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

16489563

Citation

Chung, Sheng-Liang, et al. "677TT Polymorphism of Methylenetetrahydrofolate Reductase in Combination With Low Serum Vitamin B12 Is Associated With Coronary In-stent Restenosis." Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions, vol. 67, no. 3, 2006, pp. 349-55.
Chung SL, Chiou KR, Charng MJ. 677TT polymorphism of methylenetetrahydrofolate reductase in combination with low serum vitamin B12 is associated with coronary in-stent restenosis. Catheter Cardiovasc Interv. 2006;67(3):349-55.
Chung, S. L., Chiou, K. R., & Charng, M. J. (2006). 677TT polymorphism of methylenetetrahydrofolate reductase in combination with low serum vitamin B12 is associated with coronary in-stent restenosis. Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions, 67(3), 349-55.
Chung SL, Chiou KR, Charng MJ. 677TT Polymorphism of Methylenetetrahydrofolate Reductase in Combination With Low Serum Vitamin B12 Is Associated With Coronary In-stent Restenosis. Catheter Cardiovasc Interv. 2006;67(3):349-55. PubMed PMID: 16489563.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - 677TT polymorphism of methylenetetrahydrofolate reductase in combination with low serum vitamin B12 is associated with coronary in-stent restenosis. AU - Chung,Sheng-Liang, AU - Chiou,Kuan-Rau, AU - Charng,Min-Ji, PY - 2006/2/21/pubmed PY - 2006/9/1/medline PY - 2006/2/21/entrez SP - 349 EP - 55 JF - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JO - Catheter Cardiovasc Interv VL - 67 IS - 3 N2 - BACKGROUND: Recent studies have shown that a common mutation (nucleotide 677 C-->T) in the methylenetetrahydrofolate reductase (MTHFR) gene may contribute to a mild rise in plasma homocysteine levels and increase the incidence of coronary artery disease. Therefore, this study was designed to further investigate whether the effects of MTHFR 677 C to T mutation, plasma homocysteine, serum vitamin B12, and folate can influence restenosis after successful coronary stenting. METHODS AND RESULTS: We investigated 260 patients each with a lesion after successful coronary stent placement. All patients received a repeated angiography after 6 months, or earlier if clinically indicated. Angiographic in-stent restenosis (ISR) was defined as >or=50% diameter stenosis at follow-up. Genotyping for MTHFR was based on a polymerase chain reaction technique. Also fasting plasma homocysteine, vitamin B12, and folate levels were measured at the same time. The ISR rate was higher among the patients with the TT genotype than in those with the non-TT genotypes (64.0% versus 32.9%, P=0.002). There was no significant difference in plasma homocysteine levels among patients with the TT genotype and patients with the non-TT genotypes (15.9+/-7.6 versus 15.5+/-6.6 micromol/L, P=0.75). However, among the patients with the TT genotype, those with higher plasma homocysteine levels (>or=12 micromol/L) demonstrated a significantly higher ISR rate (75.0% versus 33.5%, P=0.001). Logistic regression analysis revealed that the combined presence of the MTHFR TT genotype and lower than average serum vitamin B12 (>or=550 pg/mL) resulted in the most significant difference in the risk of ISR (OR=3.57, CI=1.51-8.46, P=0.004; OR=2.36, CI=1.35-4.15, P=0.003). CONCLUSIONS: MTHFR 677TT polymorphism and low serum vitamin B12 each individually increased the risk of coronary ISR. Furthermore, the combination of these parameters resulted in a greater increase in risk. SN - 1522-1946 UR - https://www.unboundmedicine.com/medline/citation/16489563/677TT_polymorphism_of_methylenetetrahydrofolate_reductase_in_combination_with_low_serum_vitamin_B12_is_associated_with_coronary_in_stent_restenosis_ L2 - https://doi.org/10.1002/ccd.20663 DB - PRIME DP - Unbound Medicine ER -