Apo E4 and lipoprotein-associated phospholipase A2 synergistically increase cardiovascular risk

Atherosclerosis. 2012 Jul;223(1):230-4. doi: 10.1016/j.atherosclerosis.2012.04.021. Epub 2012 May 8.

Abstract

Objective: Apolipoprotein E (apoE) has been implicated as conveying increased risk for coronary artery disease (CAD). Previous studies suggest a role of apoE as a modulator of immune response and inflammatory properties. We hypothesized that the presence of apo E4 is associated with an increased inflammatory burden in subjects with CAD as compared to subjects without CAD.

Methods: ApoE genotypes, systemic (C-reactive protein [CRP], fibrinogen, serum amyloid-A [SAA]) and vascular inflammatory markers (Lipoprotein-associated phospholipase A(2) [Lp-PLA(2)] and pentraxin-3 [PTX-3]) were assessed in 324 Caucasians and 208 African Americans, undergoing coronary angiography.

Results: For both ethnic groups, Lp-PLA(2) index, an integrated measure of Lp-PLA(2) mass and activity, increased significantly and stepwise across apoE isoforms (P = 0.009 and P = 0.026 for African Americans and Caucasians respectively). No differences were found for other inflammatory markers tested (CRP, fibrinogen, SAA and PTX-3). For the top cardiovascular score tertile, apo E4 carriers had a significantly higher level of Lp-PLA(2) index in both ethnic groups (P = 0.027 and P = 0.010, respectively).

Conclusion: The presence of the apo E4 isoform was associated with a higher level of Lp-PLA(2) index, a marker of vascular inflammation. Our results suggest that genetic variation at the apoE locus may impact cardiovascular disease risk through enhanced vascular inflammation.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • 1-Alkyl-2-acetylglycerophosphocholine Esterase
  • Analysis of Variance
  • Apolipoprotein E4 / genetics*
  • Biomarkers / blood
  • Black or African American / genetics
  • C-Reactive Protein / analysis
  • Coronary Angiography
  • Coronary Artery Disease / blood
  • Coronary Artery Disease / diagnostic imaging
  • Coronary Artery Disease / ethnology
  • Coronary Artery Disease / genetics*
  • Coronary Artery Disease / immunology*
  • Cross-Sectional Studies
  • Fibrinogen / analysis
  • Gene Frequency
  • Genetic Predisposition to Disease
  • Humans
  • Inflammation / blood
  • Inflammation / ethnology
  • Inflammation / genetics*
  • Inflammation / immunology*
  • Inflammation Mediators / blood*
  • Phenotype
  • Phospholipases A2 / blood*
  • Risk Assessment
  • Risk Factors
  • Serum Amyloid A Protein / analysis
  • Serum Amyloid P-Component / analysis
  • United States / epidemiology
  • White People / genetics

Substances

  • Apolipoprotein E4
  • Biomarkers
  • Inflammation Mediators
  • Serum Amyloid A Protein
  • Serum Amyloid P-Component
  • PTX3 protein
  • Fibrinogen
  • C-Reactive Protein
  • Phospholipases A2
  • 1-Alkyl-2-acetylglycerophosphocholine Esterase
  • PLA2G7 protein, human