Machal Jan, Vasku Anna, Hlinomaz Ota, Linhartova Petra, Groch Ladislav, Vitovec Jiri
Department of Pathophysiology, Faculty of Medicine, Masaryk University Brno, Czech Republic.
Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2012 Jun;156(2):151-8. doi: 10.5507/bp.2012.051.
The impact of ApoE polymorphism on angiographic parameters was assessed in patients referred for coronary angiography.
Elective coronary angiography was performed in 671 subjects (525 men, 146 women, mean age 60 ± 10 years) with symptoms of ischemic heart disease. The patients were divided into: no CAD group (smooth coronary vessels, n=83), one-vessel (n=155), two-vessel (n=170) and three-vessel disease (n=196). Patients with stenoses 0-50% were excluded. Within patients with CAD, we evaluated overall extent of CAD measured by the number of stenotic segments according to AHA (1 segment vs. 2-3 vs. ≥4), and the severity of the most serious stenosis (in percent). ApoE genotype was determined using real-time PCR.
The frequency of ε2/ε3 genotype (n=56) was lower in the three-vessel disease group compared to one-vessel disease (OR=0.25, P=0.0019), two-vessel disease (OR=0.31, P=0.0114) or no CAD group (OR=0.24, P=0.0057). Frequency of ε2/ε3 decreased with the number of affected segments (1 vs. ≥4: OR=0.35, P=0.0143). The ε3/ε4+ε4/ε4 genotypes (n=123) were more frequent in CAD patients altogether compared with no CAD group (OR=2.30, P=0.019), while no impact of the ε4 allele on angiographic parameters within the CAD patients was detected. In ε2/ε3 carriers with CAD, lower LDL-cholesterol, total cholesterol and lower use of lipid-lowering drugs were observed.
The results show predominantly focal form of CAD in patients with ε2/ε3 genotype. Lower LDL-cholesterol and total cholesterol may play the key role, although other contributing factors are discussed.
在因冠状动脉造影而就诊的患者中评估载脂蛋白E（ApoE）基因多态性对血管造影参数的影响。
对671例有缺血性心脏病症状的受试者（525例男性，146例女性，平均年龄60±10岁）进行择期冠状动脉造影。患者被分为：无冠心病组（冠状动脉血管光滑，n = 83）、单支血管病变组（n = 155）、双支血管病变组（n = 170）和三支血管病变组（n = 196）。狭窄程度为0 - 50%的患者被排除。在冠心病患者中，我们根据美国心脏协会（AHA）标准，通过狭窄节段数量评估冠心病的总体范围（1个节段vs. 2 - 3个节段vs.≥4个节段），以及最严重狭窄的程度（以百分比表示）。使用实时聚合酶链反应（PCR）测定ApoE基因型。
与单支血管病变组（比值比[OR]=0.25，P = 0.0019）、双支血管病变组（OR = 0.31，P = 0.0114）或无冠心病组（OR = 0.24，P = 0.0057）相比，三支血管病变组中ε2/ε3基因型（n = 56）的频率较低。ε2/ε3的频率随着受累节段数量的增加而降低（1个节段vs.≥4个节段：OR = 0.35，P = 0.0143）。与无冠心病组相比，冠心病患者中ε3/ε4 + ε4/ε4基因型（n = 123）的频率总体上更高（OR = 2.30，P = 0.019），而未检测到ε4等位基因对冠心病患者血管造影参数有影响。在患有冠心病的ε2/ε3携带者中，观察到较低的低密度脂蛋白胆固醇、总胆固醇水平以及较低的降脂药物使用率。
结果显示ε2/ε3基因型患者的冠心病主要为局灶性形式。尽管讨论了其他影响因素，但较低的低密度脂蛋白胆固醇和总胆固醇可能起关键作用。
