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Meta-Analysis
. 2022 Mar 24;22(1):126.
doi: 10.1186/s12872-022-02566-0.

Meta-analysis of the association between Apolipoprotein E polymorphism and risks of myocardial infarction

Aiyu Shao #  1 , Jikang Shi #  1 , Zhuoshuai Liang  1 , Lingfeng Pan  1 , Wenfei Zhu  1 , Sainan Liu  1 , Jiayi Xu  1 , Yanbo Guo  1 , Yi Cheng  2 , Yichun Qiao  3
Affiliations
Meta-Analysis

Meta-analysis of the association between Apolipoprotein E polymorphism and risks of myocardial infarction

Aiyu Shao et al. BMC Cardiovasc Disord. .

Abstract

Background: Myocardial infarction (MI) remains the leading cause of death and disability among cardiovascular diseases worldwide. Studies show that elevated low-density lipid protein cholesterol (LDL-C) levels confer the highest absolute risk of MI, and Apolipoprotein E (ApoE) is implicated in regulating levels of triglycerides (TGs), cholesterol, and LDL-C. Our study aimed to evaluate the association between APOE polymorphism and MI, and to provide evidence for the etiology of MI.

Methods: Case-control studies on the association between APOE polymorphisms and the risk of myocardial infarction were included by searching PubMed, Web of Science, and CNKI, and this meta-analysis was written in accordance with PRISMA guideline statement. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using either random-effects or fixed-effects models by R software.

Results: A total of 33 eligible articles involving 13,706 cases and 14,817 controls were finally selected. The pooled analysis based on the total eligible articles showed that the risk of MI was associated with ApoE epsilon 2 and epsilon 4 alleles. The results showed that patients with MI had a low frequency of the ε2 allele (OR 0.74, 95% CI 0.64-0.86) and a high frequency of the ε4 allele (OR 1.24, 95% CI 1.09-1.42).

Conclusions: APOE ε2-involved genotypes may be protective factors for MI; in contrast, ε4-involved genotypes (ε4/ε3 vs. ε3/ε3, and ε4/ε4 vs. ε3/ε3) may be risk factors for MI.

Keywords: Apolipoprotein E polymorphism; Meta-analysis; Myocardial infarction.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow chart of the process for literature identification and selection
Fig. 2
Fig. 2
Forest plot for the association between myocardial infarction risk and APOE ε2 allele vs. ε3 allele (A); forest plot for the association between myocardial infarction risk and APOE ε4 allele vs. ε3 allele (B)
Fig. 3
Fig. 3
Forest plot for association between APOE polymorphism and MI risks in genotypes: A ε2/ε3 vs. ε3/ε3; B ε3/ε4 vs. ε3/ε3; C ε4/ε4 vs. ε3/ε3; D ε2/ε2 vs. ε3/ε3; E ε2/ε4 vs. ε3/ε3
Fig. 4
Fig. 4
Forest plot of subgroup analysis of the association between APOE alleles/genotypes and myocardial infarction
Fig. 5
Fig. 5
Trial sequential analysis of the association between ApoE genotype ε2/ε2 vs. ε3/ε3 and myocardial infarction
See this image and copyright information in PMC

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