ELSEVIER Atherosclerosis 175 (1996) 2099216 atherosclerosis Apolipoprotein E polymorphism does not predict risk of restenosis after coronary angioplasty Nilesh J. Samani”*b%*, Daniel S. Martinb, Michael Bra&‘, James Cullen”, Robert Wallis”, David Lodwick”, Anoop Chauhand, Alex Harley”, John R. Thompson”, Anthony H. Gershlick”, David P. de Bono “Department of’ Cardiology, Uniwrsity of’ Leiwstrr, Leicester, UK bDrpartment of’ Medicine, C’nicer.sit.v of’ Leicester, Leicester. UK ‘Department of’ Ophthalmology:, Unicersity of’ Leicestrr. Leicrster, UK dRegional Cardiac Unit, Papworth Hospital, Cambridge . UK ‘The Cardiothoratic Cwrtrr. Liwrpool, L’K Received 10 January 1996: accepted 3 April 1996 Abstract A recent report has suggested that the E4 allele of apolipoprotein (ape) E increases the risk of restenosis after percutaneous transluminal coronary angioplasty (PTCA) and also that it interacts synergistically with the deletion (D) allele of the angiotensin-converting enzyme (ACE) to increase the risk sixteen-fold. To investigate this further, we genotyped 231 subjects with successful PTCA who underwent planned repeat angiography at 4 months to assess the degree of restenosis. Subjects carrying the apo E4 allele (n = 71) were well matched with non-carriers (n = 160) for clinical and pre- and post-PTCA angiographic features. We found no increase in either apo E4 allele frequency (18.4’% versus 15.6%, P = 0.42) or apo E4 homozygosity (21106versus 51125,P = 0.30) in those with restenosis compared with those without. The relative risk of restenosis for apo E4 carriers was 1.11 (95% CI = 0.87- 1.42). In apo E4 carriers, restenosis frequency was similar in those also carrying the ACE D allele and those without (28/55 (50.9%) versus 9116(56.2%) P = 0.71) and there was no significant increase in restenosis risk in carriers of both the apo E4 and ACE D alleles compared to the rest (odds ratio 1.30, 95% CI 0.68-2.50, P = 0.39). We conclude that in our cohort, the apo E4 allele does not either independently or acting synergistically with the ACE D allele increase the risk of restenosis after PTCA, and that apo E genotyping will not be a useful predictor of risk before the procedure. Keywov1.s: PICA; Restenosis; Genes; Apolipoprotein E: Angiotensin-converting enzyme * Corresponding author, Department of Cardiology, Clinical SciencesWing, Glenfield General Hospital, Groby Road. Leicester LE3 9QP. UK. Tel.: +44 116 2563236; Fax: +44 116 2875792. 0021-915096 RlS.00 0 1996 Elsevier Science Ireland Ltd. All rights reserved PII SO02 l-9 150(96)05879-O