Severity of angiographic coronary obstruction and the apolipoprotein E polymorphism in acute coronary syndromes.
BACKGROUND
There is evidence of the association between the apolipoprotein E (APOE) and coronary disease; however, there are controversies.


OBJECTIVE
To evaluate the association between the number of coronary vessels with significant obstruction defined by angiography, the APOE polymorphism and clinical variables.


METHODS
This was a cross-sectional, multicenter study with 207 patients (138 men), with acute coronary syndrome (ACS), in the city of Niteroi, state of Rio de Janeiro, Brazil, who underwent coronary angiography and genotype determination for the APOE *2*3*4 polymorphism by the Restriction Fragment Length Polymorphism (RFLP) method.


RESULTS
The frequency of the alleles was APOE *2 - 6.8%, *3 - 82.5%, *4 - 10.7%. Regarding the number of affected vessels, 27% of patients presented monoarterial obstruction, 33.8% biarterial and 39.1% triarterial and/or left coronary trunk. The degree of multivascular lesion did not correlate with the presence of the *4 allele (p= 0.78), but with age > 55 years (p=0.025), being an ex-smoker (p=0.004) and dyslipidemia (p=0.05) at the multivariate analysis and also with previous coronary artery disease (CAD) (p=0.05), diabetes (p=0.038) and metabolic syndrome (p=0.021) at the univariate analysis. The prevalence of dyslipidemia, diabetes and systemic arterial hypertension (SAH) was elevated regarding similar studies, with progressive increases in the prevalence of SAH (p=0.59) and diabetes (p=0.06), according to the number of affected vessels.


CONCLUSIONS
The APOE polymorphism was not associated with the number of coronary vessels with significant obstruction at any age range. On the other hand, age > 55 years, being an ex-smoker and dyslipidemia associated with the multivascular lesion.
Dias
Arlisa Monteiro de Castro
AM
Hospital Universitário Antonio Pedro, Faculdade de Medicina, Universidade Federal Fluminense, Niterói, RJ, Brazil. arlisa@predialnet.com.br
Reis
Amália Faria dos
AF
Saud
Claudia Guerra Murad
CG
Chilinque
Maria das Graças Leitão
Md
Leite
Rafaela Ferreira
RF
Abdalah
Rosemery Nunes Cardoso
RN
Fiqueiredo
Mariana Ferreira
MF
Ribeiro
Georgina Severo
GS
Faria
Carlos Augusto Cardozo de
CA
D054058:Acute Coronary Syndrome / Q000235:genetics / Q000473:pathology; D000367:Age Factors; D001057:Apolipoproteins E / Q000235:genetics*; D017023:Coronary Angiography; D050171:Dyslipidemias / Q000150:complications; D004812:Epidemiologic Methods; D005260:Female; D005787:Gene Frequency / Q000235:genetics*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011110:Polymorphism, Genetic / Q000235:genetics*; D012907:Smoking / Q000009:adverse effects
D001057:Apolipoproteins E