Role of PLA2 polymorphism on clinical events after percutaneous coronary intervention

Objectives: We examined the relationship between the PLA2 polymorphism of the platelet GPIIIa receptor and major adverse cardiac events (MACE) after percutaneous coronary intervention (PCI). Background: PLA2 polymorphism has been associated with increased thrombosis and myocardial infarction. The association of PlA2 with MACE post-PCI has not been determined. Methods: 200 patients with normal baseline CKMB undergoing non-urgent PCI for symptomatic coronary artery disease were tested for the PLA2 polymorphism and followed for 1 year while on aspirin and clopidogrel. MACE were recorded and adjudicated by an independent, blinded committee. Results: Baseline demographic and lesion characteristics, platelet aggregation, activated clotting time and use of GP Ilb/llla blockers were similar between the 2 groups. The normal (A1A1), heterozygous (A1A2), and homozygote (A2A2) variants were found in 144 (72%), 55 (27.5%), and 1 (0.5%) patients, respectively. The presence of the PLA2 genetic polymorphism had no influence on 1-year MACE: 7.1% for the A1A1 group versus 6.5% for the A1A2 group (P=NS). The rate of any CKMB elevation post-PCI was 39% vs. 38% respectively (P=NS). Conclusion: In this study, the GPIIIa PlA2 polymorphism was frequent (27.5%), but the homozygous variant was very infrequent (0.5%). The presence of PLA2 had no influence on peri-procedural or one-year clinical outcomes.