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Interleukin-6 Promoter Genotype and Restenosis after Femoropopliteal Balloon Angioplasty: Initial Observations¹

¹ From the Departments of Medical and Chemical Laboratory Diagnostics (M.E., C.M., O.W.) and Angiology (M.S., E.M., W.M., S.S., G.E., M.R.), University of Vienna Medical School, Waehringer Guertel 18–20, A-1090 Vienna, Austria. Received May 3, 2003; revision requested July 11; final revision received September 11; accepted October 21. M.E. and M.S. supported by grant P15231 from the Fonds zur Förderung der Wissenschaftlichen Forschung. Address correspondence to O.W. (e-mail: oswald.wagner@univie.ac.at).

PURPOSE: To investigate whether there is an association between a functional polymorphism in the interleukin (IL)-6 gene promoter (–174)G/C and restenosis after percutaneous transluminal angioplasty (PTA) of the femoropopliteal artery.

MATERIALS AND METHODS: A total of 281 patients underwent PTA of the femoropopliteal artery during the study period; 23 (8%) patients had to be excluded due to missing genetic data. We studied 258 patients with intermittent claudication (n = 174) or critical limb ischemia (n = 84). The IL-6 promoter genotype was determined from venous blood samples before intervention by using a mutagenically separated polymerase chain reaction, and patients were followed up for 6 months with duplex ultrasonography for the occurrence of restenosis (50%) after angioplasty. Multivariate Cox proportional hazards analysis was performed to assess the association between the IL-6 promoter genotype and restenosis, with adjustment for possible confounders such as atherosclerotic risk factors and angiographic covariates.

RESULTS: The 6-month restenosis rate was 26% (23 of 90) in patients with the (–174)GG genotype, 28% (33 of 117) with the (–174)GC genotype, and 43% (22 of 51) with the (–174)CC genotype (P = .044). Homozygous carriers of the (–174)C allele ([–174]CC) exhibited a 2.42-fold increased adjusted risk for restenosis (95% CI: 1.28, 4.58; P = .007) compared with homozygous (–174)G allele carriers ([–174]GG). Heterozygous carriers ([–174]GC) had no significantly increased restenosis risk (hazard ratio, 1.37; 95% CI: 0.84, 2.22; P = .21).

CONCLUSION: The IL-6 promoter polymorphism (–174)G/C seems to influence the occurrence of restenosis after PTA. Homozygous carriers of the (–174)C allele have an increased rate of intermediate-term restenosis.

© RSNA, 2004

Index terms: Arteries, femoral • Arteries, popliteal • Arteries, restenosis, 92.458, 92.721 • Arteries, transluminal angioplasty, 92.1282, 92.454 • Genes and genetics

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