载脂蛋白E基因多态性与急性心肌梗死及经皮冠状动脉介入治疗后阿司匹林抵抗的相关性
Correlation of ApoE gene polymorphism with acute myocardial infarction and aspirin resistance after percutaneous coronary intervention.
作者信息
Wang Luoqing, Shao Chen, Han Cuimin, Li Peng, Wang Feixiang, Wang Yilian, Li Junping
机构信息
Department of Cardiovascular Medicine, Lianyungang Second People's Hospital Affiliated to Bengbu Medical College Lianyungang 222006, Jiangsu, China.
Department of Electrocardiogram, Lianyungang Second People's Hospital Affiliated to Bengbu Medical College Lianyungang 222006, Jiangsu, China.
出版信息
Am J Transl Res. 2022 May 15;14(5):3303-3310. eCollection 2022.
OBJECTIVE
To determine the correlation of Apolipoprotein E (ApoE) gene polymorphism with acute myocardial infarction (AMI) and aspirin (APC) resistance after percutaneous coronary intervention (PCI).
METHODS
In this randomized controlled trial (The Second People's Hospital of Lianyungang Ethics Committee No.L1719), a total of 120 AMI patients admitted to the Second People's Hospital of Lianyungang from January 2019 to June 2020 were enrolled into the research group (Res group) and 120 healthy individuals during the same time period into the control group (Con group). ApoE gene polymorphism was detected by gene microarray and analyzed statistically. The occurrence of APC resistance after PCI was recorded, and the relationship between ApoE gene polymorphism and APC resistance was analyzed.
RESULTS
The Res group showed a significantly lower level of ε3/ε3 gene and significantly higher levels of ε3/ε4 and ε4/ε4 genes than the Con group (all P<0.05), but no notable difference was found in the distribution of ApoE ε2 between the two groups (P>0.05). ApoE ε3 carriers were the main carriers in both groups. However, the Res group showed a lower frequency of ApoE ε3 and a higher frequency of ApoE ε4 compared to the Con group (both P<0.05), and patients with more severe AMI had a significantly higher frequency of ApoE ε4 genotype (P<0.05). According to logistic regression analysis, carrying ApoE ε4 allele (ε3/ε4, ε4/ε4) was a risk factor for AMI (P<0.05). Additionally, patients with APC resistance had a significantly higher frequency of ApoE ε4 allele than those without it (P<0.05). A higher frequency of ApoE ε4 allele was also a risk factor of APC resistance in AMI patients after PCI, and its adjusted risk ratio (OR) was 2.26 times (P<0.05). Moreover, no significant difference was observed among patients with different ApoE genotypes in the incidence of adverse events (P>0.05).
CONCLUSION
ApoE gene polymorphism is correlated with AMI and APC resistance after PCI, and ApoE ε4 genotype is probably the risk allele for AMI.
目的
确定载脂蛋白E（ApoE）基因多态性与急性心肌梗死（AMI）以及经皮冠状动脉介入治疗（PCI）后阿司匹林抵抗（APC）之间的相关性。
方法
在这项随机对照试验（连云港市第二人民医院伦理委员会批准号：L1719）中，选取2019年1月至2020年6月在连云港市第二人民医院收治的120例AMI患者纳入研究组（Res组），同期选取120例健康个体纳入对照组（Con组）。采用基因芯片检测ApoE基因多态性并进行统计学分析。记录PCI后APC抵抗的发生情况，分析ApoE基因多态性与APC抵抗之间的关系。
结果
Res组中ε3/ε3基因水平显著低于Con组，ε3/ε4和ε4/ε4基因水平显著高于Con组（均P<0.05），但两组间ApoE ε2的分布无显著差异（P>0.05）。两组中ApoE ε3携带者均为主要携带者。然而，Res组中ApoE ε3的频率低于Con组，ApoE ε4的频率高于Con组（均P<0.05），且AMI病情越严重，ApoE ε4基因型的频率越高（P<0.05）。根据逻辑回归分析，携带ApoE ε4等位基因（ε3/ε4、ε4/ε4）是AMI的危险因素（P<0.05）。此外，发生APC抵抗的患者中ApoE ε4等位基因的频率显著高于未发生者（P<0.05）。ApoE ε4等位基因频率较高也是PCI后AMI患者发生APC抵抗的危险因素，其调整后的风险比（OR）为2.26倍（P<0.05）。而且，不同ApoE基因型患者的不良事件发生率无显著差异（P>0.05）。
结论
ApoE基因多态性与AMI及PCI后APC抵抗相关，ApoE ε4基因型可能是AMI的风险等位基因。
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