RELATION OF CORONARY ATHEROSCLEROSIS AND APOLIPOPROTEIN-E GENOTYPES IN ALZHEIMER PATIENTS

Background and Purpose Apolipoprotein E (apoE) epsilon 4 allele has be en associated with a high risk for coronary heart disease. Increased f requency of the epsilon 4 allele has also been reported in patients wi th late-onset familial and sporadic Alzheimer's disease (AD). The aim of this study was to investigate the degree of coronary and cerebral a therosclerosis in a neuropathologically verified series of AD patients with different apoE genotypes. In addition, we studied the relationsh ip between the degree of coronary and cerebral atherosclerosis and the extent of beta-amyloid (A beta) accumulation. Methods We studied 38 s ubjects (32 patients with definite AD and 6 age-matched control subjec ts) for whom postmortem autopsy delay was less than 8 hours. ApoE geno types were identified through Hha I digestion of the polymerase chain reaction-amplified samples. We used A beta immunohistochemistry to det ect diffuse and neuritic plaques as well as cerebrovascular amyloid. T he degree of coronary and cerebral atherosclerosis was rated as none, mild, moderate, or severe. Results The apoE genotypes of the AD patien ts were epsilon 4/4 2, epsilon 3/4 19, epsilon 3/3 9, and epsilon 3/2 2. We found more severe atherosclerosis of the coronary vessels among AD patients with the apoE epsilon 4 allele compared with those AD pati ents without the epsilon 4 allele (chi(2)=4.1, df=1, P<.05). The exten t of cerebral atherosclerosis did not differ among AD subgroups with a nd without the epsilon 4 allele. The degree of coronary or cerebral at herosclerosis was not related to the amount of amyloid accumulation in the frontal and temporal cortices or in the hippocampal structures. C onclusions This study confirms the association of apoE epsilon 4 allel e with coronary atherosclerosis in AD patients.