OBJECTIVE

To study the effect of the CCR5 rs746492 gene polymorphism on clinical course of coronary artery disease (CAD) and results of percutaneous coronary interventions (PCI).

MATERIAL AND METHODS

The study included 84 patients with CAD. Mean age of patients was 57.2±2.1 years. There were 3 groups of patients: group 1 (19 patients) — carriers of the AA rs746492 CCR5 genotype; group 2 (41 patients) — carriers of the genotype AG rs746492 CCR5; group 3 (24 patients) — carriers of the GG rs746492 CCR5 genotype. Mean number of stented coronary arteries was 1.4±0.2, 1.4±0.1 and 1.5±0.1; number of stents — 1.6±0.2, 1.7±0.1 and 2.0±0.2, respectively. Mean follow-up period was 6.5±0.3 years after PCI.

RESULTS

The effect of the CCR5 rs746492 gene polymorphism (carriage of the GG genotype) on clinical course of CAD and results of PCI was characterized by more severe diffuse lesions of coronary arteries and higher SYNTAX Score (11.7±1.3, 11.0±0.94 and 14.7±1.3 in carriers of genotypes AA, AG and GG, respectively), more severe and extensive stress-induced myocardial ischemia (Duke index –9.6±0.5, –9.7±0.8 and –11.2±0.4 in carriers of genotypes AA, AG and GG, respectively), higher total rate of adverse cardiovascular events (recurrence of angina pectoris + myocardial infarction + cardiovascular death) in mid-term period after PCI (32%, 41% and 67% in carriers of genotypes AA, AG and GG, respectively) and higher total rate of adverse angiographic results (stent restenosis + progression of coronary atherosclerosis + stent thrombosis) in mid-term period after PCI (32%, 41% and 71% in carriers of genotypes AA, AG and GG, respectively).

CONCLUSION

Polymorphism of the CCR5 rs746492 gene (carriage of GG genotype) significantly impacts on clinical course of CAD, widespread diffuse coronary artery disease, more severe and extensive stress-induced ischemia. This is associated with the risk of adverse angiographic and clinical results after PCI.