American Heart Journal
Volume 157, Issue 5 , Pages 908-912, May 2009

Vitamin K epoxide reductase complex subunit 1 gene polymorphism is associated with atherothrombotic complication after drug-eluting stent implantation: 2-Center prospective cohort study

  • Jung-Won Suh, MD

      Affiliations

    • Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea
    • ,
  • Sang-Hong Baek, MD, PhD

      Affiliations

    • Department of Internal Medicine, College of Medicine, Catholic University of Korea, Seoul, South Korea
    • Corresponding Author InformationReprint requests: Hyo-Soo Kim, MD, PhD and Sang-Hong Baek, MD, PhD, Department of Internal Medicine, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul, 110-744, South Korea.
    • ,
  • Jin-Shik Park, MD

      Affiliations

    • Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea
    • ,
  • Hyun-Jae Kang, MD

      Affiliations

    • Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea
    • ,
  • In-Ho Chae, MD

      Affiliations

    • Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea
    • ,
  • Dong-Ju Choi, MD

      Affiliations

    • Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea
    • ,
  • Hun-Jun Park, MD

      Affiliations

    • Department of Internal Medicine, College of Medicine, Catholic University of Korea, Seoul, South Korea
    • ,
  • Pum-Joon Kim, MD

      Affiliations

    • Department of Internal Medicine, College of Medicine, Catholic University of Korea, Seoul, South Korea
    • ,
  • Ki-Bae Seung, MD

      Affiliations

    • Department of Internal Medicine, College of Medicine, Catholic University of Korea, Seoul, South Korea
    • ,
  • Hyo-Soo Kim, MD, PhD

      Affiliations

    • Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea
    • Corresponding Author InformationReprint requests: Hyo-Soo Kim, MD, PhD and Sang-Hong Baek, MD, PhD, Department of Internal Medicine, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul, 110-744, South Korea.

Received 4 August 2008; accepted 1 February 2009. published online 23 March 2009.

Background

Single nucleotide polymorphisms of vitamin K epoxide reductase complex subunit 1 (VKORC1) was reported to have association with arterial vascular disease. We investigated whether single nucleotide polymorphism of VKORC1 +2255 is associated with clinical outcomes among patients who underwent drug-eluting stent (DES) implantation.

Methods

We prospectively collected genomic DNA in patients who underwent DES deployment from September 2003 to December 2006 and compared clinical outcomes according to their VKORC1 genotype at the locus + 2255 (rs 2359612). The primary end point was composite of atherothrombotic events (cardiac death, myocardial infarction, and nonhemorrhagic stroke).

Results

Mean follow-up duration was 631 ± 251 days. Genotyping was completed in 764 cases (TT genotype [n = 640, 83.8%] vs non-TT [CC or CT] genotype [n = 124, 16.2%]). Non-TT group showed more composite events than TT group (7.3% vs 3.0%, P = .032). In the Cox regression analysis, non–TT genotype of VKORC gene was a significant predictor of atherothrombotic events (hazard ratio 2.56, 95% confidence interval 1.14-5.78). In the event-free survival analysis, non–TT group also showed significantly poorer cardiovascular events-free survival rate than TT group (P = .02).

Conclusions

VKORC1 genotype is associated with cardiovascular events in patients with DES implantation, suggesting the role of coagulation system.

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 This study was supported by the grants from the Korea Health 21 R&D Project, Ministry of Health and Welfare, Republic of Korea (0412-CR02-0704-0001), and the Innovative Research Institute for Cell Therapy (A062260).

PII: S0002-8703(09)00102-1

doi:10.1016/j.ahj.2009.02.001

American Heart Journal
Volume 157, Issue 5 , Pages 908-912, May 2009

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