Gene polymorphisms in APOE, NOS3, and LIPC genes may be risk factors for cardiac adverse events after primary CABG.
BACKGROUND
Coronary artery disease progression after primary coronary artery bypass grafting may, beside classical atherosclerosis risk factors, be depending on genetic predisposition.


METHODS
We investigated 192 CABG patients (18% female, age: 60.9 +/- 7.4 years). Clinically cardiac adverse events were defined as need for reoperation (n = 88; 46%), reintervention (n = 58; 30%), or angina (n = 89; 46%). Mean follow-up time measured 10.1 +/- 5.1 years. Gene polymorphisms (ApoE, NOS3, LIPC, CETP, SERPINE-1, Prothrombin) were investigated separately and combined (gene risk profile).


RESULTS
Among classical risk factors, arterial hypertension and hypercholesterinemia significantly influenced CAD progression. Single ApoE, NOS3 and LIPC polymorphisms provided limited information. Patients missing the most common ApoE epsilon 3 allele (5,2%), showed recurrent symptoms (p = 0,077) and had more frequently reintervention (p = 0,001). NOS3 a allele was associated with a significant increase for reintervention (p = 0,041) and recurrent symptoms (p = 0,042). Homozygous LIPC patients had a higher reoperation rate (p = 0.049). A gene risk profile enabled us to discriminate between faster and slower occurrence of cardiac adverse events (p = 0.0012).


CONCLUSIONS
Single APOE, LIPC and NOS3 polymorphisms permitted limited prognosis of cardiac adverse events in patients after CABG. Risk profile, in contrast, allowed for risk stratification.
Eifert
Sandra
S
Department of Cardiac Surgery, Ludwig Maximilians University Munich, Germany. seifert@med.uni-muenchen.de
Rasch
Astrid
A
Beiras-Fernandez
Andres
A
Nollert
Georg
G
Reichart
Bruno
B
Lohse
Peter
P
D001057:Apolipoproteins E / Q000235:genetics*; D015331:Cohort Studies; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D018450:Disease Progression; D005260:Female; D020022:Genetic Predisposition to Disease; D006331:Heart Diseases / Q000235:genetics* / Q000517:prevention & control; D006801:Humans; D006937:Hypercholesterolemia / Q000150:complications; D006973:Hypertension / Q000150:complications; D008049:Lipase / Q000235:genetics*; D008297:Male; D008875:Middle Aged; D052250:Nitric Oxide Synthase Type III / Q000235:genetics*; D011110:Polymorphism, Genetic; D012150:Polymorphism, Restriction Fragment Length; D012086:Reoperation; D012307:Risk Factors; D016896:Treatment Outcome
D001057:Apolipoproteins E; C504173:LIPC protein, human; D052250:Nitric Oxide Synthase Type III; D008049:Lipase
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