Distribution of the methylenetetrahydrofolate reductase A1298C polymorphism among patients undergoing endovascular treatment for lower-extremity arterial disease
DOI:
https://doi.org/10.18203/2349-2902.isj20261984Keywords:
Hyperhomocysteinemia, Angioplasty, Stenting, MTHFR A1298 polymorphism, GenotypeAbstract
Background: The methylenetetrahydrofolate reductase (MTHFR) A1298C polymorphism reduces enzyme activity, leading to impaired homocysteine (Hcy) metabolism and moderate hyperhomocysteinemia. Elevated Hcy promotes endothelial dysfunction and accelerates atherosclerosis, increasing the risk of cardiovascular disease. Peripheral arterial disease may progress to critical limb ischemia, often requiring endovascular revascularization such as angioplasty with stenting.
Methods: This retrospective study consisted of 69 patients divided into 58 males and 11 females. The inclusion criteria for this study consist of patients diagnosed with chronic arterial insufficiency according to the Fontaine classification, patients with informed consent, patients who underwent lower-extremity revascularization, patients with surgical indication of atherosclerotic lesions and the exclusion criteria included patients without arterial chronic sufficiency, patients without obtained informed consent, patients with more than one intervention.
Results: Out 69 patients, 16 patients were found with hemodynamically significant atherosclerotic lesions in the aortofermoral segment, 37 in the femorotibial segment and 16 in both segments. The distribution of MTHFR A1298C polymorphisms with AA genotype was 37 patients (53.6%) with AC genotype was 21 patients (30.4%) and with CC genotype was 11 patients (16.0%).
Conclusions: This study revealed the most predominant revascularization procedure was angioplasty combined with stenting, accounting for 55.1% of all interventions. The most prevalent allele of the MTHFR A1298C genetic polymorphism was normal AA genotype in patients with lower-extremity arterial disease who underwent isolated endovascular or hybrid interventions on the main arteries were detected in 37 (53.6%) patients.
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