Genomics of In-Stent Restenosis

Our laboratory is investigating the genetic basis of the vascular disease, in-stent restenosis. We hypothesize that patients with in-stent restenosis have abnormal expression of cell cycle regulatory and inflammatory genes that lead to accelerated development of vascular lesions following angioplasty, and that there is a genetic component underlying individual differences to vascular injury. We are conducting an investigation of human subjects with in-stent restenosis, entitled the CardioGene Study. The objective of the CardioGene study is to identify the genetic profile of patients at risk for in-stent restenosis. The CardioGene study completed enrollment of 465 patients in December 2004. Analysis of blood gene expression profiles, proteomic and genotyping data is currently ongoing. All analyses are conducted using peripheral blood. Concurrent analysis of restenosis tissue samples would be valuable in defining the molecular genetics of the disease.

In this complementary study of endartectomy tissues, we will collect diseased restenosis tissues removed from patients as part of their routine clinical care. We will also collect blood at the time of tissue harvesting for genomic analysis, in addition to clinical data. Genomic data will be compared to the CardioGene study findings, for the purposes of validation as well as more detailed understanding of the biology of restenosis, by investigation the molecular mechanisms of restenosis in the tissue samples.