Apolipoprotein E polymorphism is associated with both number of diseased vessels and extent of coronary artery disease in Czech patients with CAD

Abstract

Aims. The impact of ApoE polymorphism on angiographic parameters was assessed in patients referred for coronary angiography. Methods. Elective coronary angiography was performed in 671 subjects (525 men, 146 women, mean age 60±10 years) with symptoms of ischemic heart disease. The patients were divided into: no CAD group (smooth coronary vessels, n=83), one-vessel (n=155), two-vessel (n=170) and three-vessel disease (n=196). Patients with stenoses 0-50% were excluded. Within patients with CAD, we evaluated overall extent of CAD measured by the number of stenotic segments according to AHA (1 segment vs. 2-3 vs. ≥4), and the severity of the most serious stenosis (in percent). ApoE genotype was determined using real-time PCR. Results. The frequency of ε2/ε3 genotype (n=56) was lower in the three-vessel disease group compared to one-vessel disease (OR=0.25, P=0.0019), two-vessel disease (OR=0.31, P=0.0114) or no CAD group (OR=0.24, P=0.0057). Frequency of ε2/ε3 decreased with the number of affected segments (1 vs. ≥4: OR=0.35, P=0.0143). The ε3/ε4+ε4/ε4 genotypes (n=123) were more frequent in CAD patients altogether compared with no CAD group (OR=2.30, P=0.019), while no impact of the ε4 allele on angiographic parameters within the CAD patients was detected. In ε2/ε3 carriers with CAD, lower LDL-cholesterol, total cholesterol and lower use of lipid-lowering drugs were observed. Conclusions. The results show predominantly focal form of CAD in patients with ε2/ε3 genotype. Lower LDL-cholesterol and total cholesterol may play the key role, although other contributing factors are discussed.

A 6-Month Follow-Up Study of the Relation between Apolipoprotein E Gene Polymorphism and Major Adverse Cardiovascular Events in Patients with Acute Coronary Syndrome

“…ApoE33 genotypes (72.5%) were the most common genotypes. This is a universal finding for human populations that was supported by many previous studies [9][10][11][12]. The frequency of the ApoE2 alleles (E22 + E23) and ApoE4 alleles (E34 + E44) is 9 and 18.5%, respectively.…”

“…They found that there were no statistically significant differences between ApoE genotypes and severity of CAD by using the Gensini score. However, the study team of Dr. Jan Machal [9] reported different results. They found that the frequency of the ApoE23 genotype was lower in the 3-vessel disease group compared to 1-vessel disease, 2-vessel disease or no CAD group.…”

“…We excluded patients with any of the following characteristics: (1) cardiogenic shock; (2) acute exacerbation of chronic obstructive pulmonary disease with pulmonary infection; (3) history of coronary artery bypass surgery; (4) history of peptic ulcer and/or gastrointestinal bleeding; (5) renal failure with a creatinine level of ≥3 mg/dL and/or an estimated glomerular filtration rate < 30 mL/ min/1.73 m 2 ; (6) stroke within the previous 30 days; (7) history of hyperthyroidism; (8) severe noncardiac organic disease or neoplastic disease, estimated survival time less than 6 months; or (9) refusal to sign informed consent to participate in the study.…”

The APOE ε2 allele is associated with increased plasma apolipoprotein E levels in patients with coronary artery disease

“…Ačkoliv předchozí studie prokázaly souvislost nosičství alely 2 s nižším výskytem nemoci tří tepen a fokálním charakterem lézí [12], v našem souboru jsme neprokázali žádný vztah mezi genotypem APOE a rozsahem koronární aterosklerózy (nemoc více tepen, komplexní léze B2/C) nebo výskytem akutních koronárních syndromů. Taktéž jsme neprokázali signifi kantní rozdíly v systolické funkci traci APOE a taktéž up-regulaci jaterních receptorů LDL a snížení koncentrace LDL cholesterolu [5].…”