Objective: In-stent restenosis (ISR) is the narrowing of a stented coronary artery lesion. A considerable number of patients undergoing percutaneous coronary intervention (PCI) are affected by ISR. The predominant mechanism in the development of ISR is an inflammatory response to vessel wall injury during PCI. Vitamin D is reported to have anti-inflammatory properties, so it may also be related with ISR. Therefore, in this study the relationship between vitamin D receptor (VDR), vitamin D binding protein (VDBP) gene variations and ISR were investigated. Methods: Fifty-eight ISR patients who have chest pain, underwent angiography and were found to have restenosis in the previously inserted stent were included in the patient group and thirty-five patients who have chest pain and were not found to have restenosis in their previous stent in coronary angiography were included in the control group. rs7041 and rs4588 variations in VDBP; rs1544410 and rs2228570 variations in VDR were investigated by real-time polymerase chain reaction (RT-PCR). Results were evaluated statistically. Results: The CC genotype of rs2228570 variation of VDR and the CA genotype of rs4588 variation of VDBP were found statistically high in patient group. rs7041 variation was found statistically high in patients who had myocardial infarction history before stent implantation. Additionally, it was demonstrated that vitamin D deficiency (vitamin D level
OBJECTIVES: Recent research demonstrated that classic infl ammatory mediators were responsible for the development of stent thrombosis. We aimed to examine the relationship between predictors such as basophils, mean platelet volume (MPV), and vitamin D, which represented allergic, infl ammatory, and antiinfl ammatory states, and stent thrombosis after percutaneous coronary intervention. METHODS: In this observational case-control study, patients (n: 87) with ST-elevated myocardial infarction (STEMI) with stent thrombosis formed group 1, and (n = 90) with STEMI without stent thrombosis formed group 2. 25-OH vitamin-D and other laboratory values were obtained at the time of admission to the emergency room. RESULTS: In comparison to group 2, MPV was higher in group 1(9.05±0.89 vs 8.17±1.37 fL, respectively; p=0.002). Group 2 had a higher basophil count than group 1(0.03±0.05 vs 0.07±0.080; p=0.001). In comparison to group 2, group 1 had a greater vitamin-D level (p=0.014). The MPV and basophil count were found as predictors for stent thrombosis in the multivariable logistic analyses. When MPV increased by one unit, the risk of stent thrombosis increased 1.69-times (95% CI: 1.038-3.023). Basophil counts below 0.02 increased the risk of stent thrombosis 12.74-times (95% CI: 4.22-36.00). CONCLUSION: Increased MPV and basophil depletion might be predictors for coronary stent thrombosis following percutaneous coronary intervention (Tab. 4, Fig. 2, Ref. 25).
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