Single nucleotide polymorphism (G994-->T) in the plasma platelet-activating factor-acetylhydrolase gene is associated with graft patency of femoropopliteal bypass.
BACKGROUND
Plasma platelet-activating factor-acetylhydrolase (PAF-AH) is known to catalyze platelet-activating factor (PAF). The single nucleotide polymorphism (SNP) of plasma PAF-AH gene (G994 -->T in exon 9) is associated with a decreased level of plasma PAF-AH activity. This study analyzed the risk of the SNP on graft occlusion of femoropopliteal bypass in patients with atherosclerotic occlusive disease.


METHODS
We retrospectively assessed the patency of 50 above-knee femoropopliteal bypass grafting in 50 patients. Genomic DNA was analyzed for the mutant allele. Plasma PAF-AH activity was measured by radioimmunoassay.


RESULTS
The 10-year cumulative primary patency of the bypass was 78.5% in GG (normal genotype) and 50.0% in GT (heterozygous) or TT (homozygous deficient) (P <.05, Kaplan-Meier method). The relative risk of graft failure in GT or TT genotypes was 1.68 (P =.08, Cox proportional hazards model). PAF-AH activity (nmol/min/50 microL) was 1.92 +/- 0.82 in patients with patent grafts and 1.42 +/- 0.47 in those with occluded grafts (mean +/- standard deviation; P <.05, unpaired t test).


CONCLUSIONS
The SNP of plasma PAF-AH was associated with a decreased primary graft patency of above-knee femoropopliteal bypass. The risk of graft failure may increase when patients have the SNP. To confirm the independent risk of graft failure by the SNP, further study is necessary and prospective study should be performed.
Unno
Naoki
N
Second Department of Surgery, Hamamatsu University School of Medicine, Japan.
Nakamura
Toshio
T
Mitsuoka
Hiroshi
H
Saito
Takaaki
T
Miki
Keita
K
Ishimaru
Kei
K
Sugatani
Junko
J
Miwa
Masao
M
Nakamura
Satoshi
S
D043203:1-Alkyl-2-acetylglycerophosphocholine Esterase; D000368:Aged; D001157:Arterial Occlusive Diseases / Q000235:genetics / Q000601:surgery; D019917:Blood Vessel Prosthesis Implantation; D005260:Female; D005263:Femoral Artery / Q000601:surgery*; D005838:Genotype; D006083:Graft Occlusion, Vascular / Q000235:genetics; D006801:Humans; D008297:Male; D010741:Phospholipases A / Q000235:genetics*; D010972:Platelet Activating Factor / Q000235:genetics*; D020641:Polymorphism, Single Nucleotide; D011150:Popliteal Artery / Q000601:surgery*; D012189:Retrospective Studies; D012307:Risk Factors; D014654:Vascular Patency / Q000235:genetics*
D010972:Platelet Activating Factor; D010741:Phospholipases A; D043203:1-Alkyl-2-acetylglycerophosphocholine Esterase