Joint effects of PPARG-C161T (rs3856806) polymorphism and cardiovascular risk factors on restenosis risk after coronary stent implantation

Abstract Objectives The peroxisome proliferator-activated receptor gamma (PPARG) C161T polymorphism (rs3856806) may be a risk factor for in-stent restenosis (ISR) due to its known associations with type 2 diabetes (T2DM), obesity, and coronary artery disease (CAD). This study aims to investigate the relationship between PPARG-C161T polymorphism and the risk of ISR, considering clinical features. Methods According to the results of coronary angiography, the patients who had undergone drug-eluting stent implantation were categorized into two groups: ISR (n=116) and non-ISR (n=265). The control group consisted of 140 healthy subjects with asymptomatic for CAD or any systemic disease. PPARG-C161T genotypes were determined using the real-time polymerase chain reaction melting curve analysis. Results T2DM, hypertension, and hyperlipidemia were observed as the main clinical features causing non-ISR and ISR. The 161-CC genotype was associated with an increased risk of ISR compared to both controls (p=0.014) and non-ISR patients (p=0.008). This difference remained statistically significant after multivariate analysis for non-ISR patients (p=0.003) but not for the ISR group. The prevalence of hypertension and hyperlipidemia was higher in ISR patients with T2DM than in non-ISR patients with T2DM (p=0.002 and p=0.009, respectively). Multivariate logistic regression analysis in subgroups based on the presence of T2DM showed that hypertension (p<0.001) was associated with ISR in patients with T2DM. Conclusions This study points out the association between the PPARG 161-CC genotype and the risk of ISR, which also means that the PPARG 161-T allele is protective against ISR. However, this effect could be divergent in the presence of the metabolic components of the restenosis phenotype, especially T2DM.