Meta-analysis of the association between Apolipoprotein E polymorphism and risks of myocardial infarction

Abstract

Background Myocardial infarction (MI) remains the leading cause of death and disability among cardiovascular diseases worldwide. Studies show that elevated low-density lipid protein cholesterol (LDL-C) levels confer the highest absolute risk of MI, and Apolipoprotein E (ApoE) is implicated in regulating levels of triglycerides (TGs), cholesterol, and LDL-C. Our study aimed to evaluate the association between APOE polymorphism and MI, and to provide evidence for the etiology of MI. Methods Case–control studies on the association between APOE polymorphisms and the risk of myocardial infarction were included by searching PubMed, Web of Science, and CNKI, and this meta-analysis was written in accordance with PRISMA guideline statement. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using either random-effects or fixed-effects models by R software. Results A total of 33 eligible articles involving 13,706 cases and 14,817 controls were finally selected. The pooled analysis based on the total eligible articles showed that the risk of MI was associated with ApoE epsilon 2 and epsilon 4 alleles. The results showed that patients with MI had a low frequency of the ε2 allele (OR 0.74, 95% CI 0.64–0.86) and a high frequency of the ε4 allele (OR 1.24, 95% CI 1.09–1.42). Conclusions APOE ε2-involved genotypes may be protective factors for MI; in contrast, ε4-involved genotypes (ε4/ε3 vs. ε3/ε3, and ε4/ε4 vs. ε3/ε3) may be risk factors for MI.

Association of Common Variants of APOE, CETP, and the 9p21.3 Chromosomal Region with the Risk of Myocardial Infarction: A Prospective Study

“…Associations of APOE polymorphism and MI risks have been investigated extensively [ 11 ]. In 2014, H. Xu et al performed a meta-analysis, finding that the frequency of MI increases for ε4ε4 vs. ε3ε3 (OR 1.59, 95% CI 1.15–2.19, p = 0.005); conversely, no significant association was detected for ε2ε2 vs. ε3ε3 (OR 0.73, 95% CI 0.40–1.32, p = 0.29) [ 12 ].…”

“…For our study, we selected genes that have been significantly associated with MI or coronary artery disease (CAD) in meta-analyses: chromosomal region 9p21.3 [ 6 , 7 , 8 ], the CETP gene [ 9 , 10 ], and the APOE gene [ 11 , 12 ].…”

“…Apolipoprotein E (APOE) is a major chylomicron apolipoprotein and is required for the normal catabolism of triglyceride-rich lipoprotein components [ 15 , 16 ]. The results of a recent meta-analysis conducted by A. Shao et al revealed that APOE ɛ2-involving genotypes may be protective factors against MI; in contrast, ɛ4-involving genotypes may be risk factors for MI [ 11 ]. These results are consistent with findings of a meta-analysis of APOE gene polymorphism and susceptibility to MI performed by H. Xu et al in 2014 [ 12 ].…”

“…Taking into account the meta-analyses of the associations of genes APOE and CETP and chromosomal region 9p21.3 with the risk of MI [ 6 , 7 , 8 , 9 , 10 , 11 , 12 ], data from pilot studies showing an association of these variants with the risk of MI in other populations [ 4 , 5 ], and preliminary data on the correlation of these variants with metabolic disorders leading to MI [ 6 , 14 , 15 , 16 ], we chose common variants in APOE , CETP , and genes located in 9p21.3 to evaluate their possible association with MI.…”

Association of APOE (rs429358 and rs7412) and PON1 (Q192R and L55M) Variants with Myocardial Infarction in the Pashtun Ethnic Population of Khyber Pakhtunkhwa, Pakistan

“…Moreover, three alleles (ɛ2(388 T–526 T), ɛ3(388 T-526C), ɛ4(388C-526C)) and six genotypes (ɛ2/ɛ2, ɛ2/ɛ3, ɛ2/ɛ4, ɛ3/ɛ3, ɛ3/ɛ4 and ɛ4/ɛ4) can be formed by the two SNPs [ 24 , 25 ]. Since allele 3 is the most prevalent in populations, it is referred to as “wild-type.”The alleles 2 and 4 are considered variants [ 26 ]. Various studies have reported their association with MI in different ethnicities such as Chinese and Russian etc.…”