Role of the APOE polymorphism in carotid and lower limb revascularization: A prospective study from Southern Italy

Abstract

Background Atherosclerosis is a complex multifactorial disease and the apolipoprotein E (APOE) polymorphism has been associated to vascular complications of atherosclerosis. Objectives To investigate the relationship between the APOE genotypes and advanced peripheral vascular disease. Materials and methods 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. Results 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). Conclusions 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.