Research article

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

Sandra Eifert¹ , Astrid Rasch¹ , Andres Beiras-Fernandez¹ , Georg Nollert¹ , Bruno Reichart¹ and Peter Lohse²

¹  Department of Cardiac Surgery, Ludwig Maximilians University Munich, Germany

²  Department of Clinical Chemistry, Ludwig Maximilians University Munich, Germany

author email corresponding author email

Journal of Cardiothoracic Surgery 2009, 4:46doi:10.1186/1749-8090-4-46

Published:	19 August 2009

Abstract

Introduction

Coronary artery disease progression after primary coronary artery bypass grafting may, beside classical atherosclerosis risk factors, be depending on genetic predisposition.

Methods

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 (ApoE, NOS3, LIPC, CETP, SERPINE-1, Prothrombin) were investigated separately and combined (gene risk profile).

Results

Among classical risk factors, arterial hypertension and hypercholesterinemia significantly influenced CAD progression. Single ApoE, NOS3 and LIPC polymorphisms provided limited information. Patients missing the most common ApoE ε3 allele (5,2%), showed recurrent symptoms (p = 0,077) and had more frequently reintervention (p = 0,001). NOS3 a allele was associated with a significant increase for reintervention (p = 0,041) and recurrent symptoms (p = 0,042).

Homozygous LIPC patients had a higher reoperation rate (p = 0.049).

A gene risk profile enabled us to discriminate between faster and slower occurrence of cardiac adverse events (p = 0.0012).

Conclusion

Single APOE, LIPC and NOS3 polymorphisms permitted limited prognosis of cardiac adverse events in patients after CABG. Risk profile, in contrast, allowed for risk stratification.