Apolipoprotein epsilon 4 homozygosity--a determinant of restenosis after coronary angioplasty.
Conventional coronary risk factors have not consistently been found to be related to restenosis after coronary angioplasty. Apolipoprotein E (apo E) gene polymorphism and/or plasma apo(a) levels were determined in 195 subjects undergoing prospective follow up and angiographic study 6 months after elective balloon angioplasty of a previously untreated coronary obstruction. Restenosis (stenosis > or = 50% plus loss of > or = 50% of initial gain) had occurred in 59 of 150 subjects for whom E genotypes were available. The apo epsilon 4 allele frequency in those with restenosis was higher than those without (0.20 vs. 0.10, P < 0.01), attributable to an excess of epsilon 4 homozygotes in the restenosis group (5 of 59 vs. 1 of 91, P < 0.04). Restenosis was not related to plasma apo(a) and the apo epsilon 4 allele was not associated with elevated levels of apo(a) as has been reported elsewhere. No relationship was found between E genotype and serum lipid and lipoprotein levels; paradoxically, LDL cholesterol was significantly lower and HDL cholesterol higher in those with restenosis. In conclusion, homozygosity for apolipoprotein epsilon 4 appears to be an important determinant of restenosis after coronary angioplasty.
van Bockxmeer
F M
FM
Department of Biochemistry, Royal Perth Hospital, Perth, Western Australia.
Mamotte
C D
CD
Gibbons
F R
FR
Taylor
R R
RR
D000483:Alleles; D015906:Angioplasty, Balloon, Coronary; D053327:Apolipoprotein E4; D001057:Apolipoproteins E / Q000235:genetics*; D003327:Coronary Disease / Q000097:blood / Q000235:genetics / Q000628:therapy*; D005260:Female; D005838:Genotype; D006720:Homozygote; D006801:Humans; D017270:Lipoprotein(a) / Q000097:blood; D008297:Male; D008875:Middle Aged; D011110:Polymorphism, Genetic; D011446:Prospective Studies; D012008:Recurrence
D053327:Apolipoprotein E4; D001057:Apolipoproteins E; D017270:Lipoprotein(a)