677TT polymorphism of methelenetetrahydrofolate reductase in combination with low serum vitamin B12 is associated with coronary in-stent restenosis

Sheng Liang Chung, Kuan Rau Chiou, Min Ji Charng

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: Recent studies have shown that a common mutation (nucleotide 677 C→7) in the methylenetetrahydrofolate reductase (MTHFR) gene may contribute to a mild rise in plasma homocysteine levels and increase the incidence of coronary artery disease. Therefore, this study was designed to further investigate whether the effects of MTHFR 677 C to T mutation, plasma homocysteine, serum vitamin B12, and folate can influence restenosis after successful coronary stenting. Methods and Results: We investigated 260 patients each with a lesion after successful coronary stent placement. All patients received a repeated angiography after 6 months, or earlier if clinically indicated. Angiographic in-stent restenosis (ISR) was defined as ≥50% diameter stenosis at follow-up. Genotyping for MTHFR was based on a polymerase chain reaction technique. Also fasting plasma homocysteine, vitamin B12, and folate levels were measured at the same time. The ISR rate was higher among the patients with the TT genotype than in those with the non-TT genotypes (64.0% versus 32.9%, P = 0.002). There was no significant difference in plasma homocysteine levels among patients with the TT genotype and patients with the non-TT genotypes (15.9 ± 7.6 versus 15.5 ± 6.6 μmol/L, P = 0.75). However, among the patients with the TT genotype, those with higher plasma homocysteine levels (≥12 μmol/L) demonstrated a significantly higher ISR rate (75.0% versus 33.5%, P = 0.001). Logistic regression analysis revealed that the combined presence of the MTHFR TT genotype and lower than average serum vitamin B12 (≥550 pg/mL) resulted in the most significant difference in the risk of ISR (OR = 3.57, CI = 1.51-8.46, P = 0.004; OR = 2.36, CI = 1.35-4.15, P = 0.003). Conclusions: MTHFR 677TT polymorphism and low serum vitamin B12 each individually increased the risk of coronary ISR. Furthermore, the combination of these parameters resulted in a greater increase in risk.

Original languageEnglish
Pages (from-to)349-355
Number of pages7
JournalCatheterization and Cardiovascular Interventions
Volume67
Issue number3
DOIs
Publication statusPublished - Mar 1 2006
Externally publishedYes

Fingerprint

Methylenetetrahydrofolate Reductase (NADPH2)
Vitamin B 12
Stents
Homocysteine
Oxidoreductases
Genotype
Serum
Folic Acid
Mutation
Coronary Artery Disease
Fasting
Angiography
Pathologic Constriction
Nucleotides
Logistic Models
Regression Analysis
Polymerase Chain Reaction
Incidence
Genes

Keywords

  • Homocysteine
  • Methylenetetrahydrofolate reductase
  • Restenosis
  • Stent
  • Vitamin B

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging

Cite this

@article{57d0cca538ef47f481e6948f1c6f7613,
title = "677TT polymorphism of methelenetetrahydrofolate reductase in combination with low serum vitamin B12 is associated with coronary in-stent restenosis",
abstract = "Background: Recent studies have shown that a common mutation (nucleotide 677 C→7) in the methylenetetrahydrofolate reductase (MTHFR) gene may contribute to a mild rise in plasma homocysteine levels and increase the incidence of coronary artery disease. Therefore, this study was designed to further investigate whether the effects of MTHFR 677 C to T mutation, plasma homocysteine, serum vitamin B12, and folate can influence restenosis after successful coronary stenting. Methods and Results: We investigated 260 patients each with a lesion after successful coronary stent placement. All patients received a repeated angiography after 6 months, or earlier if clinically indicated. Angiographic in-stent restenosis (ISR) was defined as ≥50{\%} diameter stenosis at follow-up. Genotyping for MTHFR was based on a polymerase chain reaction technique. Also fasting plasma homocysteine, vitamin B12, and folate levels were measured at the same time. The ISR rate was higher among the patients with the TT genotype than in those with the non-TT genotypes (64.0{\%} versus 32.9{\%}, P = 0.002). There was no significant difference in plasma homocysteine levels among patients with the TT genotype and patients with the non-TT genotypes (15.9 ± 7.6 versus 15.5 ± 6.6 μmol/L, P = 0.75). However, among the patients with the TT genotype, those with higher plasma homocysteine levels (≥12 μmol/L) demonstrated a significantly higher ISR rate (75.0{\%} versus 33.5{\%}, P = 0.001). Logistic regression analysis revealed that the combined presence of the MTHFR TT genotype and lower than average serum vitamin B12 (≥550 pg/mL) resulted in the most significant difference in the risk of ISR (OR = 3.57, CI = 1.51-8.46, P = 0.004; OR = 2.36, CI = 1.35-4.15, P = 0.003). Conclusions: MTHFR 677TT polymorphism and low serum vitamin B12 each individually increased the risk of coronary ISR. Furthermore, the combination of these parameters resulted in a greater increase in risk.",
keywords = "Homocysteine, Methylenetetrahydrofolate reductase, Restenosis, Stent, Vitamin B",
author = "Chung, {Sheng Liang} and Chiou, {Kuan Rau} and Charng, {Min Ji}",
year = "2006",
month = "3",
day = "1",
doi = "10.1002/ccd.20663",
language = "English",
volume = "67",
pages = "349--355",
journal = "Catheterization and Cardiovascular Interventions",
issn = "1522-1946",
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}

TY - JOUR

T1 - 677TT polymorphism of methelenetetrahydrofolate reductase in combination with low serum vitamin B12 is associated with coronary in-stent restenosis

AU - Chung, Sheng Liang

AU - Chiou, Kuan Rau

AU - Charng, Min Ji

PY - 2006/3/1

Y1 - 2006/3/1

N2 - Background: Recent studies have shown that a common mutation (nucleotide 677 C→7) in the methylenetetrahydrofolate reductase (MTHFR) gene may contribute to a mild rise in plasma homocysteine levels and increase the incidence of coronary artery disease. Therefore, this study was designed to further investigate whether the effects of MTHFR 677 C to T mutation, plasma homocysteine, serum vitamin B12, and folate can influence restenosis after successful coronary stenting. Methods and Results: We investigated 260 patients each with a lesion after successful coronary stent placement. All patients received a repeated angiography after 6 months, or earlier if clinically indicated. Angiographic in-stent restenosis (ISR) was defined as ≥50% diameter stenosis at follow-up. Genotyping for MTHFR was based on a polymerase chain reaction technique. Also fasting plasma homocysteine, vitamin B12, and folate levels were measured at the same time. The ISR rate was higher among the patients with the TT genotype than in those with the non-TT genotypes (64.0% versus 32.9%, P = 0.002). There was no significant difference in plasma homocysteine levels among patients with the TT genotype and patients with the non-TT genotypes (15.9 ± 7.6 versus 15.5 ± 6.6 μmol/L, P = 0.75). However, among the patients with the TT genotype, those with higher plasma homocysteine levels (≥12 μmol/L) demonstrated a significantly higher ISR rate (75.0% versus 33.5%, P = 0.001). Logistic regression analysis revealed that the combined presence of the MTHFR TT genotype and lower than average serum vitamin B12 (≥550 pg/mL) resulted in the most significant difference in the risk of ISR (OR = 3.57, CI = 1.51-8.46, P = 0.004; OR = 2.36, CI = 1.35-4.15, P = 0.003). Conclusions: MTHFR 677TT polymorphism and low serum vitamin B12 each individually increased the risk of coronary ISR. Furthermore, the combination of these parameters resulted in a greater increase in risk.

AB - Background: Recent studies have shown that a common mutation (nucleotide 677 C→7) in the methylenetetrahydrofolate reductase (MTHFR) gene may contribute to a mild rise in plasma homocysteine levels and increase the incidence of coronary artery disease. Therefore, this study was designed to further investigate whether the effects of MTHFR 677 C to T mutation, plasma homocysteine, serum vitamin B12, and folate can influence restenosis after successful coronary stenting. Methods and Results: We investigated 260 patients each with a lesion after successful coronary stent placement. All patients received a repeated angiography after 6 months, or earlier if clinically indicated. Angiographic in-stent restenosis (ISR) was defined as ≥50% diameter stenosis at follow-up. Genotyping for MTHFR was based on a polymerase chain reaction technique. Also fasting plasma homocysteine, vitamin B12, and folate levels were measured at the same time. The ISR rate was higher among the patients with the TT genotype than in those with the non-TT genotypes (64.0% versus 32.9%, P = 0.002). There was no significant difference in plasma homocysteine levels among patients with the TT genotype and patients with the non-TT genotypes (15.9 ± 7.6 versus 15.5 ± 6.6 μmol/L, P = 0.75). However, among the patients with the TT genotype, those with higher plasma homocysteine levels (≥12 μmol/L) demonstrated a significantly higher ISR rate (75.0% versus 33.5%, P = 0.001). Logistic regression analysis revealed that the combined presence of the MTHFR TT genotype and lower than average serum vitamin B12 (≥550 pg/mL) resulted in the most significant difference in the risk of ISR (OR = 3.57, CI = 1.51-8.46, P = 0.004; OR = 2.36, CI = 1.35-4.15, P = 0.003). Conclusions: MTHFR 677TT polymorphism and low serum vitamin B12 each individually increased the risk of coronary ISR. Furthermore, the combination of these parameters resulted in a greater increase in risk.

KW - Homocysteine

KW - Methylenetetrahydrofolate reductase

KW - Restenosis

KW - Stent

KW - Vitamin B

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U2 - 10.1002/ccd.20663

DO - 10.1002/ccd.20663

M3 - Article

VL - 67

SP - 349

EP - 355

JO - Catheterization and Cardiovascular Interventions

JF - Catheterization and Cardiovascular Interventions

SN - 1522-1946

IS - 3

ER -