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The 5352 A allele of the pro-inflammatory caspase-1 gene predicts late-acquired stent malapposition in STEMI patients treated with sirolimus stents

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Abstract

Late-acquired stent malapposition (LASM) is a common finding after sirolimus-eluting stent (SES) implantation and may be the cause for late stent thrombosis. Inflammation may play a pivotal role in LASM just as it plays in stent restenosis. We have therefore investigated seven polymorphisms involved in inflammatory processes, related in previous reports to restenosis, on the risk of LASM in SES patients. Patients with ST-elevation myocardial infarction who underwent SES implantation and had intravascular ultrasonography (IVUS) data available for both immediate post-intervention and 9-month follow-up were included in the present study. In total, 104 patients from the MISSION! Intervention Study were genotyped for the caspase-1 5352 G/A, eotaxin 1382 A/G, CD14 260 A/G, colony stimulating factor 2 1943 C/T, IL10 −1117 C/T, IL10 4251 C/T, and the tumor necrosis factor alpha 1211 C/T polymorphisms. LASM occurred in 26/104 (25%) of patients. We found a significantly higher risk for LASM in patients carrying the caspase-1 (CASP1) 5352 A allele (RR = 2.32; 95% CI 1.22–4.42). In addition, mean neointimal growth was significantly lower in patients carrying this LASM risk allele (1.6 vs. 4.1%, p = 0.014). The other six polymorphisms related to inflammation were not significantly related to the risk of LASM. In conclusion, carriers of the 5352 A allele in the caspase-1 gene are at increased risk of developing LASM after SES implantation. If this is confirmed in larger studies, then screening for this polymorphism in patients undergoing percutaneous coronary interventions could eventually help cardiologists to better select between commercially available stents.

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Acknowledgments

S.C.B. and D.P. contributed equally to the present work.

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Authors and Affiliations

  1. Department of Cardiology C5-P, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, The Netherlands

    Sandrin C. Bergheanu, Douwe Pons, Bas L. van der Hoeven, Su-San Liem, Martin J. Schalij & J. Wouter Jukema

  2. Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands

    Sandrin C. Bergheanu, Bob Siegerink & Johanna G. van der Bom

  3. Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, The Netherlands

    Sandrin C. Bergheanu, Johanna G. van der Bom & J. Wouter Jukema

  4. Durrer Institute for Cardiogenetic Research, Amsterdam, The Netherlands

    J. Wouter Jukema

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  1. Sandrin C. Bergheanu
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  3. Bas L. van der Hoeven
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Correspondence to J. Wouter Jukema.

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Bergheanu, S.C., Pons, D., van der Hoeven, B.L. et al. The 5352 A allele of the pro-inflammatory caspase-1 gene predicts late-acquired stent malapposition in STEMI patients treated with sirolimus stents. Heart Vessels 26, 235–241 (2011). https://doi.org/10.1007/s00380-010-0046-8

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