on October 16, 2003
Published online before print October 16, 2003, doi: 10.1161/01.ATV.0000101181.81022.BF
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Submitted on July 23, 2003
Accepted on September 18, 2003
Estrogen Receptor-
Polymorphisms and Angiographic Outcome After Coronary Artery Stenting
Valeria Ferrero ;
From the Division of Cardiology, Universita del Piemonte Orientale, Ospedale Maggiore della Carita (V.F., F.R., C.V.), Novara, Italy; Department of Genetics, Biology and Biochemistry (G.M., S.G., S.C., A.P.), Universita di Torino, Italy; I.S.I. Foundation (G.M.), Villa Gualino, Torino, Italy; Department of Cardiovascular Diseases (A.V., E.U.), Ospedale Santa Croce e Carle, Cuneo, Italy; and Cardiovascular Center (W.W.), OLV Hospital, Aalst, Belgium.
* To whom correspondence should be addressed. E-mail: uslenghi.e{at}scroce.sanitacn.it.
Objective--Because of the receptor-mediated antiproliferative effects of estradiol on vascular smooth muscle cells, our study aimed at identifying a role of PvuII and XbaI polymorphisms of the 
-estrogen receptor (ER) gene in the occurrence of restenosis after coronary stent implantation (in-stent restenosis [ISR]).
Methods and Results--In 858 patients (148 women), 955 lesions were treated with stent implantation, and the PvuII C/T and XbaI G/A polymorphisms of the ER gene were determined. Quantitative angiography was performed before and after stenting and at 6-month follow-up. The allelic frequencies were similar between sexes (C/T allele, 0.43/0.57 and 0.44/0.56; P=0.9; G/A allele, 0.35/0.65 and 0.38/0.62; P=0.8; in women and men, respectively). A significantly higher ISR rate in women than in men homozygous for the T-allele of the PvuII polymorphism (42.6% versus 26.9%, P=0.03) or the G-allele of the XbaI polymorphism (41.2% versus 19.4%, P=0.04) was observed. At multivariate analysis, T/T genotype was the only independent predictor of ISR in women but not in men (odds ratio, 1.5; 95% CI, 1.0 to 2.1; P=0.03). XbaI polymorphism was no longer associated with ISR in both sexes.
Conclusions--Women homozygous for the T-allele of the PvuII polymorphism of the ER gene treated with coronary stent implantation have a higher risk of ISR than men.
Key words: restenosis • stent • women • receptors • genetics
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