Polymorphism of platelet glycoprotein IIb and risk of thrombosis and restenosis after coronary stent placement

Both glycoprotein (GP) IIb and IIIa of platelet fibrinogen receptor are pol ymorphic proteins. Unlike GPIIIa, there is little information about the cli nical significance of the GPIIb polymorphism. We designed this prospective study to assess whether patients with the human platelet antigen (HPA)-3 po lymorphism of GPIIb are more susceptible to developing thrombosis and reste nosis after coronary stent placement. We included 2,178 consecutive patient s with coronary artery disease who underwent intracoronary stent implantati on, 789 (36.2%) with HPA-3a/a, 1,023 (47.0%) with HPA-3a/b, and 366 (16.8%) with HPA-3b/b genotype. The incidence of stent thrombosis was 1.7% in HPA- 3a/a, 1.7% in HPA-3a/b, and 1.6% in HPA-3b/b patients (p = 0.999). The inci dence of stent restenosis wets 37.3% in HPA-3a/a, 36.2% in HPA-3a/b, and 34 .6% in HPA-3b/b patients (p = 0.724). Event-free survival 1 year after sten t placement was 76.1% for HPA-3a/a, 76.5% for HPA-3a/b, and 76.4% for HPA-3 b/b patients (p = 0.968). We conclude that the HPA-3 polymorphism of platel et GPIIb is not associated with an increase in the risk of thrombosis and r estenosis over 1 year after coronary stent placement. These data indicate t hat unlike the HPA-1 polymorphism of GPIIIa, the HPA-3 polymorphism of GPII b may mot serve as a useful genetic marker for the risk assessment of patie nts treated with intracoronary stenting. (C) 1999 by Excerpta Medica, Inc.