Abstract
Experimental data support a protective function of apolipoprotein E (apoE) against restenosis, the main factor limiting the long-term benefit of percutaneous coronary interventions. We investigated the possibility that the single nucleotide polymorphisms (SNPs)--219G/T, 113G/C, 334T/C, and 472C/T of the gene encoding apoE (APOE) are associated with the incidence of death and myocardial infarction or restenosis after stenting in coronary arteries. In addition, we asked whether the apoE isotype-related epsilon2/epsilon3/epsilon4 polymorphism, defined by specific allele combinations (haplotypes) of the 334T/C and 472C/T polymorphism, and other APOE haplotypes, derived from all four SNPs investigated, are associated with adverse clinical and angiographic outcomes after stenting. Our study included 1,850 consecutive patients with symptomatic coronary artery disease (CAD) who underwent stent implantation. Follow-up angiography was performed in 1,556 patients (84.1%) at 6 months after the intervention. We found that none of the APOE SNPs is associated with death and myocardial infarction or restenosis after stenting. In addition, we observed no relationship between APOE haplotypes and adverse outcomes. In conclusion, the APOE -219G/T, 113G/C, 334T/C, and 472C/T polymorphisms, either alone or in combination, do not represent genetic markers of the risk of thrombotic and restenotic complications in patients with CAD treated with coronary stenting.
Highlights
Experimental data support a protective function of apolipoprotein E against restenosis, the main factor limiting the long-term benefit of percutaneous coronary interventions
We determined the genotypes of the –219G/T, 113G/C, 334T/C, and 472C/T single nucleotide polymorphism (SNP) of APOE in 1,850 patients with coronary artery disease (CAD) who underwent stenting in coronary arteries
ApoE is able to inhibit the proliferation of lymphocytes and vascular smooth muscle cells [2, 27] and, may interfere with the cascade of events that leads to restenosis
Summary
The study included a consecutive series of 1,850 Caucasian patients with symptomatic CAD who underwent stent implantation at Deutsches Herzzentrum München and 1. The protocols of stent placement and poststenting therapy were described in detail elsewhere [21, 22]. Patients who were considered at a higher risk for ischemic complications received additional therapy with the glycoprotein IIb/IIIa blocker abciximab, which was given as a bolus injection during the stent insertion procedure and as a 12 h continuous infusion thereafter. Written informed consent was obtained from the patients for the intervention, follow-up angiography, and genotype determination. The study protocol was approved by the Institutional Ethics Committee, and the reported investigations were in accordance with the principles of the current version of the Declaration of Helsinki
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