RUDN doctors have found genetic factors that increase the risk of recurrent vascular stenosis after stent placement. The data obtained will help to adjust the treatment and choose an individual approach for patients with coronary heart disease. The results are published in Life.
Newswise — Ischemic heart disease is a lesion of the muscle tissue of the heart, which occurs due to impaired blood circulation. The main reason is the narrowing of blood vessels or stenosis, due to the growth of atherosclerotic plaque . Stenting is used to restore blood flow. This is a low-traumatic operation, in which the narrowed a section of the artery is injected with a special balloon and a mesh cylinder, a stent . The balloon inflates and expands the stent, which becomes the frame of the vessel in this area and restores normal blood supply. Despite the widespread use of stenting and constant improvements, in 4-10% of patients after this operation there is a second stenosis, already inside the stent itself. RUDN University doctors found that one of the possible factors for recurrent stenosis is genetic features.
“Among the most common factors for recurrent stenosis within a stent are gender, age, the presence of other diseases, the degree of damage to blood vessels , and even the size of the stent. However, these factors cannot explain all cases of restenosis after coronary intervention, especially after repeated stenting in the same patients. To understand how the treatment of patients with coronary artery disease should be adjusted , it is necessary to identify the mechanisms that underlie restenosis and determine the predictors of this complication ,” Kalima Timizheva, researcher of the Department of Biology and General Genetics at RUDN University.
The study included 113 stented patients and 62 healthy controls. The goal of RUDN University physicians was to study changes in DNA that can cause the occurrence of restenosis inside the stent. Some of these genetic variants have indeed been associated with restenosis .
The most significant differences were found in the DNMT3B gene. It provides DNA methylation (control of gene activity) and is involved in the regulation of various processes, including the exchange of folic acid, it is necessary oh for DNA synthesis, hematopoiesis , etc. The difference in just one nucleotide turns out to be significant - there were more carriers of the TT rs1569686 genotype among those who developed restenosis. RUDN doctors also found genetic predispositions to restenosis depending on the age of the patient - changes in the MTHFR gene for younger patients and in the MTR gene for older patients.
“Our results can be used to assess the risk of restenosis in patients with coronary heart disease, to determine the optimal tactics and individual approach in the treatment of patients with coronary heart disease before or after coronary interventions,” said Madina Azova, Doctor of Science in Biology, Head of the Department of Biology and general genetics of RUDN University.
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