2000
DOI: 10.1161/01.cir.101.12.1366
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The Apolipoprotein ε4 Allele Determines Prognosis and the Effect on Prognosis of Simvastatin in Survivors of Myocardial Infarction

Abstract: Background-Carriers of the ⑀4 allele of the apolipoprotein E gene are at a higher risk of coronary heart disease than individuals with other genotypes. We examined whether the risk of death or a major coronary event in survivors of myocardial infarction depended on apolipoprotein E genotype and whether the benefits of treatment with simvastatin differed between genotypes. Methods and Results-Cox proportional hazards models were used to analyze 5.5 years of follow-up data from 966 Danish and Finnish myocardial … Show more

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Cited by 224 publications
(137 citation statements)
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“…34,35 Clinical studies clearly indicate that statin therapies reduce the risk of cardiovascular disease in humans, including those with apoE4, and no serious adverse effects on plasma lipids have been reported. 35,36 Nevertheless, our observations suggest the need for additional studies of the interaction between the cholesterol-lowering effect of statins and genetic variations.…”
Section: Discussionmentioning
confidence: 86%
“…34,35 Clinical studies clearly indicate that statin therapies reduce the risk of cardiovascular disease in humans, including those with apoE4, and no serious adverse effects on plasma lipids have been reported. 35,36 Nevertheless, our observations suggest the need for additional studies of the interaction between the cholesterol-lowering effect of statins and genetic variations.…”
Section: Discussionmentioning
confidence: 86%
“…This in turn leads to a higher VLDL to HDL ratio which is pro‐atherogenic 13. This ultimately leads to carriers of the ApoE4 allele having a twofold increase in their mortality risk, as found in one study of myocardial infarction survivors 16. ApoE2 exhibits impaired binding of lipoproteins to the LPL receptor which leads to a decreased clearance of TG‐rich lipoproteins.…”
Section: Discussionmentioning
confidence: 98%
“…However, studies that investigated the clinical outcomes (mortality or composite cardiovascular events) showed significant benefit from statin treatment irrespective of APOE genotype effect. 7,34,35 In view of these results, the APOE genotype and statin treatment interactions do not reproducibly explain a clinically relevant amount of treatment response variability needed to justify implementation of a pharmacogenetic test before initiation of treatment. Until data from rigorous pharmacogenomic investigations provide solid evidence regarding the role of genetic variants in predicting statin efficacy and toxicity, there is little reason…”
Section: Discussionmentioning
confidence: 98%