Gene polymorphisms in <it>APOE, NOS3</it>, and <it>LIPC </it>genes may be risk factors for cardiac adverse events after primary CABG

• Main Authors: Nollert Georg, Beiras-Fernandez Andres, Rasch Astrid, Eifert Sandra, Reichart Bruno, Lohse Peter
• Format: Article
• Language: English
• Published: BMC 2009-08-01
• Series: Journal of Cardiothoracic Surgery
• Online Access: http://www.cardiothoracicsurgery.org/content/4/1/46

<p>Abstract</p> <p>Introduction</p> <p>Coronary artery disease progression after primary coronary artery bypass grafting may, beside classical atherosclerosis risk factors, be depending on genetic predisposition.</p> <p>Methods</p> <p>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 (<b><it>ApoE, NOS3, LIPC, CETP, SERPINE-1, Prothrombin</it></b>) were investigated separately and combined (gene risk profile).</p> <p>Results</p> <p>Among classical risk factors, arterial hypertension and hypercholesterinemia significantly influenced CAD progression. Single <b><it>ApoE, NOS3 </it></b>and <b><it>LIPC </it></b>polymorphisms provided limited information. Patients missing the most common <b><it>ApoE </it></b>ε3 allele (5,2%), showed recurrent symptoms (p = 0,077) and had more frequently reintervention (p = 0,001). <b><it>NOS3 </it></b>a allele was associated with a significant increase for reintervention (p = 0,041) and recurrent symptoms (p = 0,042).</p> <p>Homozygous <b><it>LIPC </it></b>patients had a higher reoperation rate (p = 0.049).</p> <p>A gene risk profile enabled us to discriminate between faster and slower occurrence of cardiac adverse events (p = 0.0012).</p> <p>Conclusion</p> <p>Single <b><it>APOE, LIPC </it></b>and <b><it>NOS3 </it></b>polymorphisms permitted limited prognosis of cardiac adverse events in patients after CABG. Risk profile, in contrast, allowed for risk stratification.</p>