The Relationship Between Risk Factor Levels and Presence of Coronary Artery Calcification is Dependent on Apolipoprotein E Genotype

Abstract

Abstract-An important research question in the study of the genetics of coronary artery disease (CAD) is whether information about genetic variation will improve our ability to predict CAD beyond established risk factors. This question is especially relevant to the goal of identifying young, asymptomatic adults with coronary atherosclerosis who would benefit most from interventions to reduce risk. Coronary artery calcification (CAC) detected by electron-beam computed tomography is a relatively new method for detecting coronary atherosclerosis in asymptomatic individuals that has been shown to be a more accurate indicator of coronary atherosclerosis in asymptomatic individuals than other noninvasive techniques. In a study of asymptomatic women (nϭ169) and men (nϭ160) between the ages of 20 and 59 representative of the Rochester, Minnesota population, we used logistic regression to ask whether the most common Apolipoprotein (Apo) E genotypes (⑀3/2, ⑀3/3, and ⑀4/3) predict the presence of CAC. The addition of information about ApoE genotypes to logistic models containing each separate risk factor did not improve prediction of CAC (PϾ0.10 in both women and men). However, there was significant evidence (PϽ0.10) that associations between variation in the probability of having CAC and variation in body mass index, plasma total cholesterol, and plasma ApoB in men and body mass index, plasma triglycerides, plasma ApoA1, and plasma ApoE in women were dependent on ApoE genotype.

Measures of Insulin Resistance Add Incremental Value to the Clinical Diagnosis of Metabolic Syndrome in Association With Coronary Atherosclerosis

“…Consistent with a recruitment strategy based on family history of premature CVD, CAC scores were higher than in population-based studies of asymptomatic samples of similar age and demographics. 30 Approximately 27% of men and 22% of women met criteria for MetSyn according to NCEP (Table 2), roughly comparable to the age-adjusted prevalence for white subjects in the Third National Health and Nutrition Examination Survey (NHANES). 1 Estimates of the prevalence of the WHO criteria were slightly lower ( Table 2).…”

Familial Aggregation of Coronary Artery Calcium in Families With Type 2 Diabetes

“…Pfolhl et al (25) observed a higher incidence and greater extent of coronary lesion calcification, as determined by intravascular ultrasound, in 46 of 146 patients with the DD genotype of the ACE gene. Kardia et al (26) did not find that the apolipoprotein E (apoE) genotypes predicted the presence of CAC in a sample of 329 men and women. There was evidence, however, that certain apoE genotypes influence the relationship between CAC and established risk factors, such as BMI.…”

Heritability of Coronary Artery Calcium Quantity Measured by Electron Beam Computed Tomography in Asymptomatic Adults

“…Apolipoprotein E genotype was found to influence the relationship between risk factors and EBCT-measured CAC presence in ECAC Study participants. 28 Ellsworth et al 29 reported a significant association in ECAC Study participants between the S128R poly- Values are presented as mean (SD) (minimum; maximum) unless otherwise noted. *Sex differences in participant characteristics were tested using t test, 2 test, and Fisher's Exact test.…”