Abstract
Background
Variations in the apolipoprotein E (apo E) gene may predict the incidence of coronary artery disease (CAD). However, the correlation between apo E polymorphism and the severity of CAD is still unclear.
Hypothesis
Apolipoprotein E polymorphism can predict CAD.
Methods
Used a case‐case study of 213 Chinese angiographically‐defined CAD patients who were screened for apo E genotypes. The characteristics of their diseased vessels were recorded.
Results
Apolipoprotein E4 carriers had > 75% stenosis, more wide‐ranging and longer vessel disease, a greater number of diseased vessels, and a higher Gensini score than apo E2 carriers or individuals with the apo E3/3 genotype. Apolipoprotein E2 carriers had ≤75% stenosis and a shorter length of vessel disease than individuals with the apo E3/3 genotype or apo E4 carriers. The severity of stenosis, length of vessel disease, and number of diseased vessels were affected by the interaction between genotype and body mass index, family history of CAD, total plasma cholesterol level, smoking history, and hypertension history.
Conclusion
The apo E4 allele may serve as an independent genetic marker predicting severity of CAD. Other CAD risk factors may accelerate the process of pathogenesis. The apo E2 allele may play a protective role. Copyright © 2010 Wiley Periodicals, Inc.
Full Text
The Full Text of this article is available as a PDF (344.7 KB).
References
- 1. Scuteri A, Bos AJG, Znderman AB. Is the apo E4 allele an independent predictor of coronary events? Am J Med 2001; 110: 28–32. [DOI] [PubMed] [Google Scholar]
- 2. Chen Q, Reis SE, Kammerer CM, et al. Apo E polymorphism and angiographic coronary artery disease severity in the Women's Ischemia Syndrome Evaluation (WISE) study. Circulation 2003; 169(1): 159–167. [DOI] [PubMed] [Google Scholar]
- 3. Burman D, Mente A. Relationship of the apo E polymorphism to plasma lipid traits among South Asians, Chinese, and Europeans living in Canada. Atherosclerosis 2009; 203: 192–200. [DOI] [PubMed] [Google Scholar]
- 4. Ilveskoski E, Loimaala A, Mercuri MF et al. Apolipoprotein E polymorphism and carotid artery intima‐media thickness in a random sample of middle‐aged men. Atherosclerosis 2000; 153(1): 147–153. [DOI] [PubMed] [Google Scholar]
- 5. Friedewald WT, Levy RI, Fredrickson DS. Estimation of the concentration of low‐density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem 1972; 18: 499–502. [PubMed] [Google Scholar]
- 6. Gensini GG. A more meaningful scoring system for determining the severity of coronary heart disease. Am J Cardio 1983; 51: 606–607. [DOI] [PubMed] [Google Scholar]
- 7. Miller SA, Pykes DD, Polesky HF. A simple salting out procedure for extracting DNA from human nucleated cells. Nucleic Acids Res 1988; 16: 125. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 8. Renges HH, Peacock R, Dunning AM, et al. Genetic relationship between the 3′‐VNTR and diallelic apolipoprotein E gene polymorphisms: haplotype analysis in individuals of European and South Asian origin. Ann Hum Genet 1992; 56: 11–33. [DOI] [PubMed] [Google Scholar]
- 9. Wenham PR, Price WH, Blundell G. Apolipoprotein E genotyping by one‐stage PCR. Lancet 1991; 337: 1158–1159. [DOI] [PubMed] [Google Scholar]
- 10. Fazio S, Horie Y, Simonet WS. Altered lipoprotein metabolism in transgenic mice expressing low levels of a human receptor‐binding‐defective apolipoprotein E variant. J Lipid Res 1994; 25: 408–413. [PubMed] [Google Scholar]
- 11. Lahoz C, Schaefer EJ, Cupples LA, et al. Apolipoprotein E genotype and cardiovascular disease in the Framingham Heart Study. Atherosclerosis 2001; 154: 529–537. [DOI] [PubMed] [Google Scholar]
- 12. Friedlander Y, Leitersdorf E, Vecsler R. The contribution of candidate genes to the response of plasma lipids and lipoproteins to dietary challenge. Atherosclerosis 2000; 152(1): 239–248. [DOI] [PubMed] [Google Scholar]
- 13. Wilson PWF, Myers RH, Larson MG. Apolipoprotein E alleles dyslipidmia and coronary artery disease, the Framingham offspring study. JAMA 1994; 272: 666–671. [PubMed] [Google Scholar]
- 14. Tada H. The E4 allele of apolipoprotein E is associated with increased restenosis after coronary angioplasty. Tokai J Exp Clin Med 2001; 26(3): 81–92. [PubMed] [Google Scholar]
- 15. Yang SL, He BX, Liu HL, et al. Apolipoprotein E gene polymorphisms and risk for coronary artery disease in Chinese Xinjiang Uygur and Han population. Chin Med Sci J 2004; 19(2): 150–154. [PubMed] [Google Scholar]
- 16. Krul ES, Tang J. Secretion of apolipoprotein E by an astrocytoma cell line. J Neurosci Res 1992; 32(2): 227–238. [DOI] [PubMed] [Google Scholar]
- 17. Humphries SE, Talmud PJ, Hawe M. ApolipoproteinE4 and coronary heart disease in middle‐aged men who smoke: a prospective study. Lancet 2001; 358: 115–119. [DOI] [PubMed] [Google Scholar]
- 18. Weintraub MS, Grosskopf I, Rassin T. Clearance of chylomicron remnants in normolipidaemic patients with coronary artery disease: case control study over three years. BMJ 1996; 312: 936–939. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 19. Martins IJ, Hone E, Foster JK, et al. Apolipoprotein E, cholesterol metabolism, diabetes, and the convergence of risk factors for Alzheimer's disease and cardiovascular disease. Mol Psychiatry 2006; 11(8): 721–736. [DOI] [PubMed] [Google Scholar]
- 20. Myllykangas L, Lammie GA, Notkola IL, et al. Apolipoprotein E (APO E) and lipoprotein lipase (LPL) gene variants and carotid atherosclerotic lesions in the oldest old: a population‐based autopsy study. Arch Gerontol Geriatr 2009; 49(1): 108–112. [DOI] [PubMed] [Google Scholar]