Background
Methods
Study population
Definition of in-stent restenosis
ALDH2*2 (Glu504Lys) polymorphism assay
Statistical analysis
Results
Eligible patients and clinical characteristics between ISR and non-ISR patients
Variable | Total (n = 531) | ISR (n = 183) | no-ISR (n = 348) | p-value |
---|---|---|---|---|
Age, years | 59.4 ± 9.8 | 58.8 ± 9.8 | 60.5 ± 9.8 | 0.069 |
Male, n (%) | 350 (65.9) | 114 (62.3) | 236 (67.4) | 0.202 |
Follow-up period, days | 363 (289–386) | 364 (294–391) | 363 (285–385) | 0.471 |
Risk factors, n (%) | ||||
Cigarette smoking | 143 (26.9) | 42 (23) | 101 (29) | 0.134 |
Alcohol drinking | 96 (18.1) | 29 (15.8) | 67 (19.3) | 0.332 |
Hypertension | 247 (46.5) | 92 (50.3) | 155 (44.5) | 0.208 |
Diabetes mellitus | 115 (21.7) | 49 (26.8) | 66 (19.0) | 0.038 |
Hyperlipemia | 31 (5.8) | 6 (3.3) | 25 (7.2) | 0.068 |
Biochemical tests | ||||
Thrombocytocrit, mmol/L | 0.19 ± 0.07 | 0.18 ± 0.04 | 0.19 ± 0.08 | 0.041 |
MPV, fl | 9.03 ± 3.0 | 8.85 ± 1.7 | 9.12 ± 3.5 | 0.338 |
HBA1C, % | 6.23 ± 1.9 | 6.53 ± 1.9 | 6.07 ± 1.9 | 0.007 |
Glucose, mmol/L | 5.43 ± 1.9 | 5.6 ± 1.9 | 5.35 ± 1.9 | 0.16 |
Serum creatinine, μmol/L | 75.7 ± 35.2 | 71.8 ± 22.4 | 77.8 ± 40.2 | 0.06 |
TC, mmol/L | 3.82 ± 1.1 | 3.79 ± 1.1 | 3.83 ± 1.2 | 0.673 |
TG, mmol/L | 1.62 ± 1.1 | 1.59 ± 0.8 | 1.64 ± 1.2 | 0.646 |
HDL, mmol/L | 1.07 ± 0.3 | 1.07 ± 0.3 | 1.07 ± 0.3 | 0.997 |
LDL, mmol/L | 2.3 ± 0.9 | 2.3 ± 0.9 | 2.29 ± 0.9 | 0.895 |
Coronary artery lesions, n (%) | < 0.001 | |||
Single-vessel disease | 225 (42.4) | 64 (35) | 161 (46.3) | |
Double-vessel disease | 168 (31.6) | 49 (26.8) | 119 (34.2) | |
Triple-vessel disease | 138 (26) | 70 (38.3) | 68 (49.3) | |
Medications, n (%) | ||||
Clopidogrel | 420 (79.1) | 156 (85.2) | 264 (75.9) | 0.011 |
Ticagrelor | 119 (22.4) | 37 (20.2) | 82 (23.6) | 0.38 |
Statins | 505 (95.1) | 179 (97.8) | 326 (93.7) | 0.036 |
ACEI/ARB | 196 (37) | 75 (41) | 121 (34.9) | 0.166 |
β-blocker | 383 (72.1) | 133 (72.7) | 250 (71.8) | 0.838 |
CCB | 158 (29.9) | 58 (32) | 100 (28.8) | 0.442 |
Antidiabetic therapy | 264 (49.7) | 99 (54.1) | 165 (47.4) | 0.143 |
Nitrate | 520 (97.9) | 181 (98.9) | 339 (97.4) | 0.251 |
ALDH2 genotype, n (%) | 0.028 | |||
ALDH2 *1/*1 | 365 (68.7) | 115 (62.8) | 250 (71.8) | |
ALDH2 *1/*2 | 151 (28.4) | 59 (32.2) | 92 (26.4) | |
ALDH2 *2/*2 | 15 (2.8) | 9 (4.9) | 6 (1.7) |
Genotype distribution of the ALDH2*2 polymorphism in ISR and non-ISR patients
Association of the ALDH2*2 polymorphism with ISR risk
Variable | Univariate analysis | Multivariate analysis | ||
---|---|---|---|---|
OR (95%) | p-value | OR (95%) | p-value | |
Age | 1.01 (0.989–1.030) | 0.378 | 1.009 (0.990–1.030) | 0.32 |
Alcohol drinking (vs non) | 0.877 (0.512–1.460) | 0.622 | 1.230 (0.651–2.319) | 0.521 |
Cigarette smoking (vs non) | 0.807 (0.506–1.264) | 0.357 | 0.654 (0.377–1.113) | 0.123 |
Diabetes mellitus (vs non) | 1.647 (1.029–2.611) | 0.035 | 1.424 (0.909–2.221) | 0.12 |
Coronary artery lesions (vs single-vessel disease) | 1.278 (0.994–1.642) | 0.057 | 1.508 (1.193–1.911) | 0.006 |
ALDH2 *2 carriers vs ALDH2 *1 homozygotes | 1.537 (1.005–2.339) | 0.046 | 1.448 (0.965–2.168) | 0.073 |
Clopidogrel | 1.697 (1.018–2.934) | 0.049 | 1.680 (1.035–2.794) | 0.039 |
Statins | 2.924 (0.992–12.503) | 0.085 | 2.493 (0.867–9.054) | 0.118 |
ACEI/ARB | 1.317 (0.872–1.982) | 0.188 | 1.052 (0.709–1.556) | 0.799 |
Nitrite | 1.739 (0.441–11.505) | 0.483 | 1.367 (0.277–9.903) | 0.718 |
Association of the ALDH2*2 polymorphism with ISR risk stratified by diabetes
Genotype, n (%) | Total | ISR | non-ISR | p-value |
---|---|---|---|---|
Patients with diabetes | 0.008 | |||
ALDH2 *1/*1 | 81 (70.4) | 27 (55.1) | 54 (81.8) | |
ALDH2 *1/*2 | 31 (27) | 20 (40.8) | 11 (16.7) | |
ALDH2 *2/*2 | 3 (2.6) | 2 (4.1) | 1 (1.5) | |
Patients without diabetes | 0.139 | |||
ALDH2 *1/*1 | 284 (68.3) | 88 (65.7) | 196 (69.5) | |
ALDH2 *1/*2 | 120 (28.8) | 39 (29.1) | 81 (28.7) | |
ALDH2 *2/*2 | 12 (2.9) | 7 (5.2) | 5 (1.8) |
Variable | univariate analysis | multivariate analysis | |||
---|---|---|---|---|---|
OR (95%) | p-value | OR (95%) | p-value | ||
Diabetes | Age | 1.018 (0.974–1.065) | 0.431 | 1.014 (0.966–0.966) | 0.574 |
Alcohol drinking (vs non) | 0.644 (0.164–2.183) | 0.495 | 0.944 (0.178–4.66) | 0.944 | |
Cigarette smoking (vs non) | 0.636 (0.187–1.929) | 0.439 | 0.436 (0.093–1.113) | 0.267 | |
Coronary artery lesions (vs single-vessel disease) | 1.095 (0.680–1.767) | 0.709 | 1.068 (0.626–1.818) | 0.808 | |
ALDH2 *2 carriers vs ALDH2 *1 homozygotes | 3.667 (1.606–8.727) | 0.002 | 4.053 (1.668–10.449) | 0.003 | |
Clopidogrel | 1.472 (0.551–4.221) | 0.451 | 0.899 (0.297–2.829) | 0.851 | |
Statins | 1.500 (0.140–32.83) | 0.743 | 1.817 (0.145–2.794) | 0.651 | |
ACEI/ARB | 1.376 (0.654–2.914) | 0.400 | 1.205 (0.528–2.748) | 0.656 | |
Non-diabetes | Age | 1.015 (0.995–1.037) | 0.145 | 1.009 (0.987–1.031) | 0.424 |
Alcohol drinking (vs non) | 0.868 (0.508–1.445) | 0.591 | 1.177 (0.581–2.374) | 0.649 | |
Cigarette smoking (vs non) | 0.801 (0.505–1.253) | 0.337 | 0.694 (0.379–1.241) | 0.225 | |
Coronary artery lesions (vs single-vessel disease) | 1.746 (1.355–2.261) | < 0.001 | 1.677 (1.284–2.200) | < 0.001 | |
ALDH2 *2 carriers vs ALDH2 *1 homozygotes | 1.191 (0.766–1.841) | 0.433 | 1.112 (0.693–1.774) | 0.657 | |
Clopidogrel | 1.918 (1.129–3.382) | 0.019 | 1.857 (1.073–3.329) | 0.031 | |
Statins | 3.333 (1.117–14.329) | 0.055 | 2.594 (0.839–11.376) | 0.138 | |
ACEI/ARB | 1.210 (0.785–1.855) | 0.385 | 1.008 (0.635–1.586) | 0.974 |