title: Apolipoprotein E polymorphism does not predict risk of restenosis after coronary angioplasty.
abstract: A recent report has suggested that the E4 allele of apolipoprotein (apo) E increases the risk of restenosis after percutaneous transluminal coronary angioplasty (PTCA) and also that it interacts synergistically with the deletion (D) allele of the angiotensin-converting enzyme (ACE) to increase the risk sixteen-fold. To investigate this further, we genotyped 231 subjects with successful PTCA who underwent planned repeat angiography at 4 months to assess the degree of restenosis. Subjects carrying the apo E4 allele (n = 71) were well matched with non-carriers (n = 160) for clinical and pre- and post-PTCA angiographic features. We found no increase in either apo E4 allele frequency (18.4% versus 15.6%, P = 0.42) or apo E4 homozygosity (2/106 versus 5/125, P = 0.30) in those with restenosis compared with those without. The relative risk of restenosis for apo E4 carriers was 1.11 (95% CI = 0.87-1.42). In apo E4 carriers, restenosis frequency was similar in those also carrying the ACE D allele and those without (28/55 (50.9%) versus 9/16 (56.2%), P = 0.71) and there was no significant increase in restenosis risk in carriers of both the apo E4 and ACE D alleles compared to the rest (odds ratio 1.30, 95% CI 0.68-2.50, P = 0.39). We conclude that in our cohort, the apo E4 allele does not either independently or acting synergistically with the ACE D allele increase the risk of restenosis after PTCA, and that apo E genotyping will not be a useful predictor of risk before the procedure.
authors.affiliation: Department of Cardiology, University of Leicester, UK.
authors.forename: N J
authors.initials: NJ
authors.lastname: Samani
authors.forename: D S
authors.initials: DS
authors.lastname: Martin
authors.forename: M
authors.initials: M
authors.lastname: Brack
authors.forename: J
authors.initials: J
authors.lastname: Cullen
authors.forename: R
authors.initials: R
authors.lastname: Wallis
authors.forename: D
authors.initials: D
authors.lastname: Lodwick
authors.forename: A
authors.initials: A
authors.lastname: Chauhan
authors.forename: A
authors.initials: A
authors.lastname: Harley
authors.forename: J R
authors.initials: JR
authors.lastname: Thompson
authors.forename: A H
authors.initials: AH
authors.lastname: Gershlick
authors.forename: D P
authors.initials: DP
authors.lastname: de Bono
mesh_terms: D000483:Alleles; D015906:Angioplasty, Balloon, Coronary; D001057:Apolipoproteins E / Q000235:genetics*; D015331:Cohort Studies; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000235:genetics* / Q000628:therapy*; D005260:Female; D005544:Forecasting; D005838:Genotype; D006801:Humans; D008297:Male; D008875:Middle Aged; D007703:Peptidyl-Dipeptidase A / Q000235:genetics; D011110:Polymorphism, Genetic; D011183:Postoperative Complications; D012008:Recurrence; D012307:Risk Factors
chemical_list: D001057:Apolipoproteins E; D007703:Peptidyl-Dipeptidase A