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Apolipoprotein E polymorphism is not a predictor for repeated coronary artery bypass surgery
Pekka Kuukasjärvi1, Matti Tarkka, Ari Mennander
1Heart Center, Tampere University Hospital and Medical School, University of Tampere, Finland. pekka.kuukasjarvi@uta.fi
Scandinavian Cardiovascular Journal : SCJ
|August 25, 2005
Summary
Genetic factors strongly predispose younger patients to repeated coronary artery bypass grafting (CABG). Older patients undergoing repeat CABG show links to hypercholesterolemia, influenced by apoE genotype.
Area of Science:
- Cardiovascular Genetics
- Coronary Artery Disease Research
- Surgical Outcomes
Background:
- Coronary graft occlusion has diverse causes, potentially including inherited factors.
- Understanding genetic predispositions is crucial for managing coronary artery disease (CAD).
Purpose of the Study:
- To investigate the genetic predisposition for repeated coronary artery bypass grafting (CABG).
- To specifically assess the role of the apolipoprotein E (apoE) epsilon4 allele as a risk factor for redo CABG.
Main Methods:
- A case-control study involving 137 matched pairs of patients who underwent repeated CABG versus first-time CABG.
- DNA analysis for apoE genotype and assessment of family history and hypercholesterolemia.
- Patients were stratified by age relative to the median age of 62 years.
Main Results:
- In patients younger than 62, a positive family history was the sole significant predictor of repeated CABG (OR=3.4).
- In older patients, hypercholesterolemia predicted repeated CABG (OR=2.1), modified by apoE genotype.
- Family history was not a significant predictor in the older age group.
Conclusions:
- Medium-term survivors of redo CABG exhibit a strong genetic predisposition for severe CAD at an earlier age, independent of hypercholesterolemia or apoE genotype.
- In older patients, redo CABG is linked to hypercholesterolemia, with potential contributions from genetic or acquired factors beyond the apoE genotype.