Apolipoprotein E ɛ3/ɛ4 genotype is associated with premature myocardial infarction: a hospital based retrospective study

TL;DR

This study found that the APOE ε3/ε4 genotype is linked to a higher risk of early heart attacks, suggesting it could help identify people at risk.

Contribution

The study identifies APOE ε3/ε4 as a novel genetic risk factor for premature myocardial infarction.

Findings

The APOE ε3/ε4 genotype was more common in PMI patients than in controls.

APOE ε3/ε4 and the presence of the ε4 allele were confirmed as independent risk factors for PMI.

Smoking, hypertension, and dyslipidemia were also significant risk factors for PMI.

Abstract

To explore the association between apolipoprotein E (APOE) gene polymorphisms and the risk of premature (age of onset: men ≤ 55 years old, women ≤ 65 years old) myocardial infarction (PMI).

This study retrospectively collected the medical records (age, gender, hypertension, diabetes mellitus, smoking, drinking, and serum lipid) of 379 PMI patients and 628 age-matched non-AMI individuals (controls), from December 2018 to March 2024. The relationship between APOE polymorphisms and PMI was analyzed.

15(1.5%) individuals carried ɛ2/ɛ2, 147(14.6%) had ɛ2/ɛ3, 16(1.6%) presented with ɛ2/ɛ4, 670(66.5%) were ɛ3/ɛ3 carriers, 149(14.8%) had ɛ3/ɛ4, and 10 (1.0%) carried ɛ4/ɛ4. The proportion of ɛ2/ɛ3 genotype was significantly lower in the PMI group than in controls (7.7% vs. 18.8%, p < 0.001), whereas the prevalence of ɛ3/ɛ4 genotype was substantially higher in the PMI group (20.6% vs. 11.3%, p < 0.001). Logistic regression analysis identified some associated factors: smoking (odds ratio [OR]: 3.057, 95% confidence interval [CI]: 2.098–4.455, p < 0.001), hypertension (OR: 4.474, 95% CI: 3.273–6.117, p < 0.001), and dyslipidemia (OR: 1.805, 95% CI: 1.333–2.443, p < 0.001). Additionally, genetic factors were associated with PMI: the APOE ɛ3/ɛ4 genotype (vs. ɛ3/ɛ3, OR: 1.548, 95% CI: 1.038–2.309, p = 0.032) and the presence of ɛ4 allele (vs. ɛ3, OR: 1.521, 95% CI: 1.033–2.241, p = 0.034) were confirmed as independent associated factors.

APOE ε3/ε4 genotype was significantly associated with PMI, suggesting that this genotype could serve as a potential genetic marker for PMI risk assessment.