Pharmacogenetic analysis of the effect of angiotensin-converting enzyme inhibitor on restenosis after percutaneous transluminal coronary angioplasty

Atsunori Okamura, Mitsuru Ohishi, Hiromi Rakugi, Tomohiro Katsuya, Yoshihiro Yanagitani, Shin Takiuchi, Yoshiaki Taniyama, Koichi Moriguchi, Hiroshi Ito, Yorihiko Higashino, Kenshi Fujii, Jitsuo Higaki, Toshio Ogihara

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Abstract

Angiotensin-converting enzyme (ACE) inhibitors are reported to prevent neointimal formation after balloon injury in animal models, but in most prospective studies in humans, ACE inhibitors failed to prevent restenosis after percutaneous transluminal coronary angioplasty (PTCA). The ACE genotype assigned by an insertion/deletion (I/D) polymorphism is known to affect the potency of ACE inhibitors in several renal diseases. The authors attempted to clarify whether the effect of ACE inhibitors on restenosis might be modified by the ACE genotype. A total of 126 patients was randomly and prospectively assigned to the control group and the imidapril group. In the imidapril group, patients received 5 mg imidapril daily, starting 1 day before PTCA and continuing for 3 to 6 months. Forty-six control (65 vessels) and 32 imidapril patients (43 vessels) completed the study. The minimal lumen diameter before and after the procedure did not differ significantly among the groups with the three genotypes (II, ID, and DD) in both the control and imidapril groups. Late luminal loss during the follow-up period was not related to the ACE genotype in the control group but was significantly related in the imidapril group (II, 0.63 ± 0.19 mm; ID + DD, 1.12 ± 0.14 mm, p < 0.05). Furthermore, in the II genotype, imidapril significantly reduced late loss and restenosis rate as defined by most of the frequently used definitions. In conclusion the ACE I/D polymorphism may influence the effect of ACE inhibitors in preventing restenosis after PTCA.

Original languageEnglish
Pages (from-to)811-822
Number of pages12
JournalAngiology
Volume50
Issue number10
DOIs
Publication statusPublished - Oct 1999
Externally publishedYes

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Okamura, A., Ohishi, M., Rakugi, H., Katsuya, T., Yanagitani, Y., Takiuchi, S., Taniyama, Y., Moriguchi, K., Ito, H., Higashino, Y., Fujii, K., Higaki, J., & Ogihara, T. (1999). Pharmacogenetic analysis of the effect of angiotensin-converting enzyme inhibitor on restenosis after percutaneous transluminal coronary angioplasty. Angiology, 50(10), 811-822. https://doi.org/10.1177/000331979905001005