The association of apolipoprotein-E ( APOE ) gene polymorphisms with coronary artery disease: a systematic review and meta-analysis

Numerous studies have investigated the role of apolipoprotein E (APOE) polymorphisms in coronary artery disease (CAD), but some controversies exist regarding the outcomes as the results were not consistent and remain uncertain. Therefore, the present meta-analysis was conducted to evaluate the association of APOE polymorphisms with coronary artery disease. All the relevant studies published in English language till August 2020 were identified by searching through various electronic databases. The complete data was independently extracted by the two researchers. The data were analyzed by using the Comprehensive Meta-Analysis program and MetaGenyo program. The pooled odds ratio was used to check the associations between CAD and APOE polymorphisms. The following genetic models were used to calculate the odds ratio: e2 vs. e3 and e4 vs. e3. In the final analysis, we include 12 studies regarding the role of APOE polymorphism in CAD. The pooled odds ratio for e4 allele was higher (OR 2.00; 95% and CI, 1.48–2.71). There is no statistical significant association for e2 allele with CAD (OR 1.38; 95% CI, 1.18–1.62). This analysis showed no publication bias exists in the current meta-analysis. Our findings suggest that the apolipoprotein e4 allele appears as a significant genetic risk factor for coronary artery disease while the e2 allele is beneficial to alleviate the CAD risk. Registered with PROSPERO International Prospective Register of Systematic Reviews. PROSPERO registration number CRD42020190464