© 1995 American Heart Association, Inc.
Articles |
Apolipoprotein E4 Phenotype Is Not an Important Risk Factor for Coronary Heart Disease or Stroke in Elderly Subjects
From the Department of Medicine, Kuopio University Hospital (J.K., L.M., M.L.), and the Department of Internal Medicine, Oulu University Hospital and Biocenter Oulu, University of Oulu (K.K., Y.A.K.), Finland.
Correspondence to Markku Laakso, MD, Department of Medicine, University of Kuopio, POB 1777, 70211 Kuopio, Finland. E-mail laakso@uku.fi.
Abstract The allele e4 (apo e4) of apolipoprotein E (apo E) has been associated with an increased risk for coronary heart disease (CHD) in cross-sectional studies in middle-aged subjects. We investigated the risk of CHD and stroke with respect to the number of apo e4 alleles in a prospective study of a Finnish nondiabetic cohort including 1067 subjects 65 to 74 years old at baseline. During the 3.5-year follow-up, CHD mortality was 2.8%, total CHD incidence 6.9%, and the cumulative occurrence of CHD (prevalence at baseline and the 3.5-year incidence combined) 17.0%. The incidence of stroke was 3.4%, and the cumulative occurrence of stroke was 6.0%. The CHD mortality was 3.4% in subjects with no apo e4 allele (n=734), 1.7% in those with one apo e4 allele (n=296), and 0% in subjects with two apo e4 alleles (n=37) (P=NS between the three groups). The incidence of CHD according to the number of apo e4 alleles was 6.9% (no apo e4 alleles), 7.4% (one apo e4 allele), and 2.7% (two apo e4 alleles), and the cumulative occurrence of CHD was 16.5%, 18.6%, and 13.5%, respectively (P=NS). The incidence of stroke was 3.8% in subjects with no apo e4 allele, 2.7% in those with one apo e4 allele, and 0% in those with two apo e4 alleles (P=NS). The cumulative occurrence of stroke was 6.0%, 6.4%, and 2.7%, respectively (P=NS). In conclusion, in contrast to middle-aged subjects, the risk of cardiovascular disease in elderly subjects with apo e4 is not increased. Consequently, the allele e4 of apo E cannot be regarded as an important risk factor for CHD or stroke in the elderly.
Key Words: apolipoprotein E • coronary disease • stroke • cardiovascular disease
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