Correlation of ApoE gene polymorphism with acute myocardial infarction and aspirin resistance after percutaneous coronary intervention

Abstract

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.

Keywords: Apolipoprotein E; acute myocardial infarction; aspirin resistance; polymorphism.