Factor V Leiden and apolipoprotein E genotypes in severe femoropopliteal atherosclerosis with restenosis.
BACKGROUND
The role of factor V (Leiden) mutation, thrombophilia, and apolipoprotein E (apoE) alleles in the pathogenesis of accelerated atherosclerosis and restenosis was studied in patients requiring reoperation within five years after femoropopliteal angioplasty with artificial grafts.


METHODS
One hundred ninety-eight consecutive patients with femoropopliteal atherosclerotic disease, reoperated for restenosis were contacted by phone and 100 of them returned for laboratory and clinical work-up. In addition to clinical evaluation and routine laboratory investigations, parameters of lipoprotein metabolism, factor V (Leiden) mutation and apolipoprotein E (apoE) allele were studied by PCR amplification of DNA and endonuclease digestion techniques.


RESULTS
A significantly higher incidence of factor V (Leiden) mutation was found in patients with atherosclerosis and restenosis, compared to 445 healthy blood donors (13/200, 6.5% vs. 34/890, 3.8%, p=0.0379). Distribution of the alleles of the apolipoprotein E (apoE) gene was different, when the patients were compared to 372 controls; however, the difference only approached the level of statistical significance (25/200, 12.5% vs. 56/744, 7.5%, p=0.0515). Comparing the two groups, the number of epsilon4 allele carriers was significantly higher among patients with restenosis (25/100, 25% vs. 53/272, 14%, p=0.0147).


CONCLUSIONS
Factor V (Leiden) mutation may influence the progression of atherosclerosis and the development of restenosis after revascularization in patients with accelerated femoropopliteal atherosclerosis. Further investigation is needed whether long-term anticoagulation has an impact or not on the course of disease in such cases. ApoE epsilon4 allele should be screened in patients with femoropopliteal atherosclerosis, because it indicates a faster progression of atherosclerosis and may predict restenosis after revascularization procedure.
Vallus
Gábor
G
Department of Vascular Surgery of Central Military Hospital, and 1st Department of Obstetrics and Gynaecology, Semmelweis University, Budapest, Róbert K. krt. 44., Hungary.
Dlustus
Béla
B
Acsády
György
G
Papp
Zoltán
Z
Skopál
Judit
J
Nagy
Zoltán
Z
Prohászka
Zoltán
Z
Romics
László
L
Karádi
István
I
Nagy
Bálint
B
D000328:Adult; D000368:Aged; D000483:Alleles; D001057:Apolipoproteins E / Q000235:genetics*; D050197:Atherosclerosis / Q000235:genetics* / Q000473:pathology*; D003251:Constriction, Pathologic; D018450:Disease Progression; D005165:Factor V / Q000235:genetics*; D005260:Female; D005269:Femur / Q000098:blood supply / Q000378:metabolism* / Q000473:pathology*; D005838:Genotype; D006262:Health; D006801:Humans; D008297:Male; D008875:Middle Aged; D009154:Mutation / Q000235:genetics; D012307:Risk Factors
D001057:Apolipoproteins E; C095381:factor V Leiden; D005165:Factor V