Identificação de genes envolvidos na síntese de proteínas de células musculares lisas com expressão aumentada em placas ateromatosas associados a hiperplasia neointimal após implante de stents não-farmacológicos: estudo GENESIS-R

Abstract

Background: Coronary restenosis is a poorly understood phenomenon that remains a challenge even in the drug-eluting stent era. This study aimed to identify genes involved in the synthesis of structural and functional proteins in smooth muscle cells with increased expression in human atheromatous plaques associated with neointimal hyperplasia after bare-metal stent implantation. Methods: Atheromatous plaques were obtained by directional atherectomy prior to stenting. A gene expression analysis was performed using the Affymetrix GeneChip system. The patients were subjected to intravascular ultrasound six months after the procedure for an in-stent volumetric analysis. The correlation between gene expression in atheromatous plaques and the percentage of in-stent intimal hyperplasia was evaluated. Results: Most patients were male (85.7%) with a mean age of 60.2 ± 11.4 years; 35.7% were diabetic, and the percentage of in-stent intimal hyperplasia was 29.9 ± 18.7%. There was no change in the percentage of in-stent intimal hyperplasia in patients with or without diabetes (29.5% vs. 30.7%; P = 0.89). There was no correlation between the stent length and the percentage of in-stent intimal hyperplasia (r = −0.26; P = 0.26), or between the stent diameter and the percentage of in-stent intimal hyperplasia (r = 0.14; P = 0.56). Eight genes related to smooth muscle cell structural and functional protein synthesis had a positive