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(Arteriosclerosis, Thrombosis, and Vascular Biology. 2003;23:2223.)
© 2003 American Heart Association, Inc.

Atherosclerosis and Lipoproteins

Estrogen Receptor- Polymorphisms and Angiographic Outcome After Coronary Artery Stenting

Valeria Ferrero; Flavio Ribichini; Giuseppe Matullo; Simonetta Guarrera; Sonia Carturan; Antonello Vado; Corrado Vassanelli; Alberto Piazza; Eugenio Uslenghi; William Wijns

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.

Correspondence to Professor Eugenio Uslenghi, MD, Chief Department of Cardiology and Cardiovascular Surgery, Ospedale Santa Croce e Carle, Via Michele Coppino, 26, 12100 Cuneo, Italy. 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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