Relation of high-density lipoprotein subfractions and apolipoprotein E isoforms to coronary disease

Area of Science:

• Cardiovascular Medicine
• Clinical Chemistry
• Genetics

Background:

• Established methods exist for determining high-density lipoprotein (HDL) subfractions.
• Apolipoprotein E (ApoE) has multiple common isoforms (epsilon 2, 3, 4) influencing lipid levels.
• The ApoE epsilon 4 allele is linked to increased coronary disease risk.

Purpose of the Study:

• To evaluate the clinical utility of HDL subfraction measurement in predicting coronary disease.
• To assess the association between Apolipoprotein E isoforms and coronary disease risk.

Main Methods:

• Systematic review of nine studies on coronary disease outcomes.
• Analysis of 10 investigations examining coronary artery disease severity.
• Review of literature on Apolipoprotein E isoforms and their association with lipid concentrations and vascular disease.

Main Results:

• Measurement of HDL2-cholesterol and HDL3-cholesterol offers no predictive advantage over total HDL-C for coronary disease.
• Apolipoprotein E epsilon 4 allele is associated with higher cholesterol and triglyceride concentrations.
• Increased vascular disease risk is observed in individuals with the Apolipoprotein E epsilon 4 allele.

Conclusions:

• Total HDL-C measurement is sufficient for coronary disease risk prediction, rendering HDL subfractions redundant.
• Apolipoprotein E genotype, particularly the epsilon 4 allele, is a significant risk factor for coronary artery disease.