Abstract
BackgroundAtherosclerosis is a complex multifactorial disease and the apolipoprotein E (APOE) polymorphism has been associated to vascular complications of atherosclerosis.ObjectivesTo investigate the relationship between the APOE genotypes and advanced peripheral vascular disease.Materials and methods258 consecutive patients (201 males and 57 females, mean age 70.83 ± 7.89 years) with severe PVD were enrolled in a 42-months longitudinal study (mean 31.65 ± 21.11 months) for major adverse cardiovascular events. At follow-up genotypes of the APOE polymorphism were investigated in blinded fashion.ResultsAs compared with ε3/ε3, in ε4-carriers a significant higher incidence of major adverse cardiovascular events (35.58% vs. 20.79%; p = 0.025) and total peripheral revascularization (22.64% vs. 5.06%; p < 0.001) was observed. Prospective analysis, showed that ε4-carriers have an increased hazard ratio for major adverse cardiovascular events (adjusted HR 1.829, 95% CI 1.017–3.287; p = 0.044) and total peripheral revascularization (adjusted HR = 5.916, 95% CI 2.405–14.554, p <0.001).ConclusionsThe ε4 allele seems to be risk factor for major adverse cardiovascular events, and in particular for total peripheral revascularization in patients with advanced atherosclerotic vascular disease.
Highlights
Atherosclerosis and associated cardiovascular diseases (CVD) represent the major cause of death and comorbidities in Western and developing countries [1, 2]
Atherosclerosis is a complex multifactorial disease and the apolipoprotein E (APOE) polymorphism has been associated to vascular complications of atherosclerosis
Prospective analysis, showed that ε4-carriers have an increased hazard ratio for major adverse cardiovascular events and total peripheral revascularization
Summary
Atherosclerosis and associated cardiovascular diseases (CVD) represent the major cause of death and comorbidities in Western and developing countries [1, 2]. Genetic susceptibility in families affected by CVD is an important predisposing factor for atherosclerosis and for the most aggressive forms of vascular disease. In this regard, numerous studies have been conducted to identify susceptibility genes, which may have a predictive role in assessing the aggressiveness of the disease and the individual cardiovascular risk [12, 13]. Numerous studies have been conducted to identify susceptibility genes, which may have a predictive role in assessing the aggressiveness of the disease and the individual cardiovascular risk [12, 13] Among these susceptibility genes, one of the most studied is the polymorphism of apolipoprotein E (APOE) gene [14, 15]. Atherosclerosis is a complex multifactorial disease and the apolipoprotein E (APOE) polymorphism has been associated to vascular complications of atherosclerosis
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