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The E4 allele of apolipoprotein E is associated with increased restenosis after coronary angioplasty
1Department of Internal Medicine, Tokai University School of Medicine, Kanagawa, Japan.
Insights
The E4 allele of apolipoprotein E (apo E) is linked to increased restenosis after percutaneous transluminal coronary angioplasty (PTCA). Patients with the E4 allele showed significantly higher restenosis rates compared to non-carriers.
Area of Science:
- Cardiovascular Genetics
- Interventional Cardiology
- Molecular Biology
Background:
- Restenosis remains a significant complication after percutaneous transluminal coronary angioplasty (PTCA).
- Apolipoprotein E (apo E) genotype, particularly the E4 allele, is implicated in lipid metabolism and cardiovascular disease risk.
- The specific impact of the apo E E4 allele on restenosis post-PTCA requires further elucidation.
Purpose of the Study:
- To investigate the association between the apolipoprotein E (apo E) E4 allele and the incidence of restenosis following percutaneous transluminal coronary angioplasty (PTCA).
Main Methods:
- A cohort of 105 male patients undergoing elective initial PTCA for significant coronary artery stenosis was analyzed.
- Patients were genotyped for apo E alleles, categorizing them into E4 carriers (E4 group) and non-carriers (E3 group).
- Restenosis was assessed via coronary angiography (CAG) at a 5-month follow-up, comparing rates between the E4 and E3 groups.
Main Results:
- The E4 group exhibited significantly higher patient restenosis rates (59.1%) compared to the E3 group (33.7%) (p < 0.05).
- Lesion restenosis rates were also significantly elevated in the E4 group (51.8%) versus the E3 group (30.9%) (p < 0.05).
- Clinical and angiographic characteristics were well-matched between the E4 and E3 groups, suggesting the E4 allele as an independent risk factor.
Conclusions:
- The apolipoprotein E E4 allele is associated with an increased risk of restenosis after percutaneous transluminal coronary angioplasty.
- These findings highlight the potential role of apo E genotype in predicting PTCA outcomes.
- Further research may explore targeted interventions based on apo E genotype to mitigate restenosis risk.
Abstract:
The aim of this study is to investigate the influence of the E4 allele of apolipoprotein E (apo E) on restenosis after percutaneous transluminal coronary angioplasty (PTCA). The subjects were 171 male patients with more than 75% luminal diameter stenotic lesions of the coronary artery who had undergone an elective initial PTCA. The PTCA was successful in 164 patients, 157 of whom completed a prospective 5 month coronary angiography (CAG) follow up to assess the degree of restenosis after their surgery. Patients with previous coronary artery bypass grafting surgery (CABG), 3 vessel disease, complete obstruction or calcified lesions of the coronary artery, cerebro-vascular disease (CVD), arteriosclerosis obliterans (ASO), and renal failure with hemodialysis were excluded, leaving 105 patients in the analysis. Subjects carrying the E4 allele (n = 22, Phenotype E4/2 = 2, E4/3 = 19, E4/4 = 1: E4 group) were well matched with non-carriers (n = 83, Phenotype E2/2 = 0, E3/2 = 4, E3/3 = 79: E3 group) for clinical, and pre-and post-PTCA angiographic features. The restenosis rates were significantly higher in the E4 group than in the E3 group (patient restenosis rate : 59.1 vs 33.7% p < 0.05, lesion restenosis rate: 51.8 vs 30.9% p < 0.05). These results suggest that the E4 allele is associated with a higher restenosis rate after PTCA.
