The Effects of PCSK9 and Apolipoprotein E Functional Gene Variations On Hypercholesterolemia and Clinical Phenotype in Restenosis Patients After Percutaneous Coronary Angioplasty

Background: In-stent-restenosis is a case restricting the benefits of percutaneous-transluminal coronary angioplasty (PTCA). PCSK9 controls LDLR levels, and variations in PCSK9, ApoE and ApoER genes may affect the development of restenosis. The aim of this study was to assess the effects of genetic variants on restenosis risk after PTCA.Methods and Results: The study groups include 109 CAD-patients with restenosis (S-CAD) and 82 CAD-patients without restenosis (open-stent,OS-CAD). SNPs were analyzed by RT- PCR. PCSK9 levels were detected via ELISA method. The distributions of ApoE Epsilon, APOER (rs5174), PCSK9 rs2182833 and rs11206510 polymorphisms were found similar between study groups while the frequency of the PCSK9 E670G G allele in S-CAD group was found significantly higher than OS-CAD patients (p= 0.015). No difference was found between study groups in terms of the serum levels of PCSK9. LDL-C was found lower and HDL-C was found higher in OS-CAD group comparing with S-CAD group (p=0.042, p=0.008, respectively). Frequencies of Type 2 DM and hyperlipidemia were also found higher in S-CAD group than OS-CAD group (p=0.007, p=0.001, respectively) while EF% was found lower in S-CAD group than OS-CAD group (p=0.007).Conclusions: Our findings indicate that although ApoE Epsilon, APOER (rs5174), PCSK9 rs2182833, rs11206510 and E670G polymorphisms has no effect on serum PCSK9 levels, PCSK9-rs505151G-allele and hyperlipidemia may be risk factors in the development of restenosis.