Abstract 1810: Vitamin K Epoxide Reductase Complex Subunit 1 (vkorc1) Gene Polymorphism is Associated with Atherothrombotic Complication after Drug-Eluting Stent Implantation : Two Center Prospective Cohort Study
Single nucleotide polymorphisms (SNPs) of Vitamin K epoxide reductase complex subunit 1 (VKORC1) affect warfarin dose response. Recently, SNP of VKORC1 +2255 was reported to have association with arterial vascular disease. However, it is not known whether SNP of VKORC1 affects clinical outcomes among patients who underwent drug-eluting stent (DES) implantation. We prospectively collected genomic DNA in patients who underwent DES deployment from Sep 2003 to Dec 2006 and compared clinical outcomes according to their VKORC1 genotype. The primary end-point was composite of atherothrombotic events [cardiac death, myocardial infarction, and non-hemorrhagic stroke]. 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 events than TT group (7.3% vs, 3.0%, p=0.032). 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=0.02). VKORC1 genotype is associated with cardiovascular events in patients with DES implantation, suggesting the role of coagulation system.