Apo E polymorphism and coronary heart disease

BACKGROUND: Apolipoprotein E (Apo E) plays an important role in atherogenes is. Apo E is polymorphic with three codominant alleles: epsilon2, epsilon3 and epsilon4. In this study we evaluated the association between epsilon4 a llele and coronary heart disease in hypercholesterolemic subjects from Spai n. SUBJECTS AND METHOD: We selected 389 subjects (56% women, mean age 57 years ) with hypercholesterolemia who had been on a 6-weeks low fat, low choleste rol diet. Measurement of lipid and lipoprotein concentrations and determina tion of apo E genotype were carried out in a centralized laboratory. RESULTS: ApoE distribution was as follows: epsilon2/epsilon3 3%, epsilon3/e psilon3 75%, epsilon3/epsilon4 20%, epsilon4 1% and epsilon2/epsilon4 1%, S ubjects were grouped into epsilon4 (n = 83) or no epsilon4 (n = 303) accord ing to the presence or absence of the epsilon4 allele. Three epsilon2/epsil on4 cases were excluded. Prevalence of coronary artery disease was 15.7% in epsilon4 and 6.9% in no epsilon4 (OR 2.49, 95% CI 1.19-5.22), The relation ship persisted significant after correction for age, sex, cardiovascular ri sk factors and serum concentrations of total cholesterol, HDL-cholesterol a nd triglycerides by multiple logistic regression analysis (OR 2.56, 95% CI 1.03-6.39). CONCLUSION: In Spain, epsilon4 carriers have a higher prevalence of coronar y artery disease than no analysis epsilon4 carriers.