Time and flow-dependent changes in the p27kip1 gene network drive maladaptive vascular remodeling

Clinical studies have identified alterations in the p27kip1 gene to be associated with divergent clinical outcomes after vein bypass grafting; however, the precise mechanisms remain poorly defined. To better understand the genes and pathways closely related to p27kip1 we used a vein graft model in which alternate flow conditions result in divergent vein graft phenotypes. Our analysis identified a group of genes with differential expression between the high-flow and low-flow vein grafts. These genes represent potential biologic targets whose activity may be altered to augment maladaptive vein graft remodeling that leads to excess intimal hyperplasia and clinical vein graft failure.