Mastroianno Sandra, Di Stolfo Giuseppe, Seripa Davide, Pacilli Michele Antonio, Paroni Giulia, Coli Carlo, Urbano Maria, d'Arienzo Carmela, Gravina Carolina, Potenza Domenico Rosario, De Luca Giovanni, Greco Antonio, Russo Aldo
Cardiology Unit, Cardiological and Vascular Department, I.R.C.C.S. "Casa Sollievo della Sofferenza", San Giovanni Rotondo, Foggia, Italy.
Complex Structure of Geriatrics, Medical Sciences Department, I.R.C.C.S. "Casa Sollievo della Sofferenza", San Giovanni Rotondo, Foggia, Italy.
PLoS One. 2017 Mar 1;12(3):e0171055. doi: 10.1371/journal.pone.0171055. eCollection 2017.
Atherosclerosis is a complex multifactorial disease and the apolipoprotein E (APOE) polymorphism has been associated to vascular complications of atherosclerosis.
To investigate the relationship between the APOE genotypes and advanced peripheral vascular disease.
258 consecutive patients (201 males and 57 females, mean age 70.83 ± 7.89 years) with severe PVD were enrolled in a 42-months longitudinal study (mean 31.65 ± 21.11 months) for major adverse cardiovascular events. At follow-up genotypes of the APOE polymorphism were investigated in blinded fashion.
As compared with ε3/ε3, in ε4-carriers a significant higher incidence of major adverse cardiovascular events (35.58% vs. 20.79%; p = 0.025) and total peripheral revascularization (22.64% vs. 5.06%; p < 0.001) was observed. Prospective analysis, showed that ε4-carriers have an increased hazard ratio for major adverse cardiovascular events (adjusted HR 1.829, 95% CI 1.017-3.287; p = 0.044) and total peripheral revascularization (adjusted HR = 5.916, 95% CI 2.405-14.554, p <0.001).
The ε4 allele seems to be risk factor for major adverse cardiovascular events, and in particular for total peripheral revascularization in patients with advanced atherosclerotic vascular disease.
动脉粥样硬化是一种复杂的多因素疾病，载脂蛋白E（APOE）基因多态性与动脉粥样硬化的血管并发症有关。
研究APOE基因分型与晚期外周血管疾病之间的关系。
连续纳入258例严重外周血管疾病患者（201例男性，57例女性，平均年龄70.83±7.89岁），进行为期42个月（平均31.65±21.11个月）的主要不良心血管事件纵向研究。随访时采用盲法调查APOE基因多态性的基因型。
与ε3/ε3相比，ε4携带者主要不良心血管事件的发生率显著更高（35.58%对20.79%；p = 0.025），总外周血管重建率也显著更高（22.64%对5.06%；p < 0.001）。前瞻性分析表明，ε4携带者发生主要不良心血管事件的风险比增加（校正后HR 1.829，95%CI 1.017 - 3.287；p = 0.044），总外周血管重建的风险比也增加（校正后HR = 5.916，95%CI 2.405 - 14.554，p <0.001）。
ε4等位基因似乎是主要不良心血管事件的危险因素，尤其是晚期动脉粥样硬化血管疾病患者总外周血管重建的危险因素。
