APOLIPOPROTEIN-E POLYMORPHISM PREDICTS DEATH FROM CORONARY HEART-DISEASE IN A LONGITUDINAL-STUDY OF ELDERLY FINNISH MEN

Background There is ample evidence from cross-sectional studies of an association between allele variation of the gene coding for apolipopro tein E (apoE) and interindividual variation in plasma lipids, and the presence of coronary heart disease (CHD). There have been no prospecti ve studies, however, to evaluate the usefulness of allelic variation o f the apoE gene for predicting CHD. Methods and Results Two samples of elderly Finnish men were followed for 5 years, one in the east (n=297 ) and the other in the southwest of Finland (n=369). At baseline, when the apoE genotypes were assessed, the men were 65 to 84 years old. At the end of the follow-up, the vital status of each man was determined , and cause of death was coded. At baseline, relative frequencies of t he three alleles-epsilon 2 epsilon 3, and epsilon 4-were 0.037, 0.827, and 0.136 in the eastern and 0.062, 0.763, and 0.175 in the southwest ern samples, respectively (chi(2)=8.89, df=2, P<.012 for difference be tween the samples). During the 5-year follow-up, a total of 28 deaths from CHD were recorded in the eastern and 42 in the southwestern sampl e. Relative CHD mortality was not heterogeneous between the samples. A mong those who died from CHD, there was a doubling of the relative eps ilon 4 allele frequency in both samples (chi(2)=4.70, df=1, P<.03 for the eastern sample; chi(2)=7.11, df=1, P<.01 for the southwestern samp le). Conclusions Allelic variation in the apoE gene is a statistically significant predictor of CHD death in these samples of elderly Finnis h men.