Abstract 12568: Plasma Levels of Apolipoprotein E and Risk of Ischemic Heart Disease in the General Population
Introduction: The apolipoprotein E (APOE) ε4 allele is associated with moderately increased risk of ischemic heart disease (IHD), and APOE ε2 homozygotes have the propensity to develop a highly atherogenic type III hyperlipoproteinemia.
Hypothesis: Whether plasma levels of apoE are associated with risk of IHD remain to be determined. We tested this hypothesis.
Methods: Using 91,697 participants from the general population, we tested whether plasma levels of apoE at enrollment were associated with future risk of IHD and myocardial infarction (MI). Because 50% of plasma apoE is attached to the HDL particle, and because HDL cholesterol levels are higher in women than in men, we normalized for HDL cholesterol by calculating an apoE/HDL cholesterol ratio.
Results: All analyses were stratified by gender, because gender and apoE levels interacted significantly in predicting IHD (p=0.03). In men, multifactorially adjusted HRs for highest versus lowest apoE tertile were 1.15 (1.04-1.27) and 1.16 (0.99-1.36) for IHD and MI, respectively. Corresponding HRs in women were 0.94 (0.84-1.05) and 1.03 (0.85-1.26). Multifactorially adjusted HRs increased from the lowest to the highest apoE/HDL cholesterol ratio tertile in men (p for trends: 2.5x10-7 and 1.0x10-6) and in women (p for trends: 0.01 and 0.06) for IHD and MI, respectively. HRs for highest versus lowest apoE/HDL cholesterol ratio tertile were 1.31 (1.18-1.45) and 1.48 (1.26-1.73) for men and 1.14 (1.02-1.27) and 1.20 (0.99-1.47) for women for IHD and MI, respectively.
Conclusions: High apoE/HDL cholesterol ratios were associated with increased risk of IHD in both men and women, whereas high plasma levels of apoE alone only associated with increased risk in men. We suggest that the apoE/HDL cholesterol ratio might reflect the fraction of apoE associated with atherogenic triglyceride-rich lipoproteins.
Author Disclosures: K.L. Rasmussen: None. A. Tybjaerg-Hansen: None. B.G. Nordestgaard: None. R. Frikke-Schmidt: None.
- © 2014 by American Heart Association, Inc.