Abstract
This review paper focuses on the genetic contribution, in particular, the association of Apolipoprotein E gene polymorphism to lipid abnormality and subsequent acute coronary syndrome in Han Chinese of China. Many researches have been published pertaining the influence of ApoE gene polymorphism on coronary artery disease, dyslipidemia and the response of statin in Han Chinese. Most of the studies in Han Chinese like other populations demonstrated that ApoE 4 allele genetically predisposes coronary artery disease, acute coronary syndrome, severity of occlusion of coronary artery and higher incidence of major adverse cardiovascular events (In Han Chinese, ApoE allele carriers demonstrated 85% increase in major adverse cardiovascular events (MACE) in six months follow up). In addition, ApoE4 allele carrier also showed both increased in LDL level and decrease response to statin therapy in dyslipidemic Han Chinese. On the other hand, ApoE2 carrier is scavenger of cholesterol and triglyceride from the blood; thus it is cardiovascular-protective. Despite positive relationship between ApoE gene polymorphism and cardiovascular pathologies, prognostic outcome and resistance to intervention, this area of research still requires extensive investigation in Han Chinese. Because, several other studies revealed either negative effect or showed no effect by ApoE gene polymorphism on cardiovascular disease. Some of the causes of such debatable results could be explained by factors such as diminutive frequency allele and expression of ApoE gene in coronary heart disease. This part of the research yet requires extensive study with bulkier sample size and retrospective in nature, in order to ascertain the influence of ApoE genotype on lipid, anti-hyperlipidemic agent and coronary heart disease. Such studies could assist us to confirm whether to test healthier subjects to predict genetic risk of coronary heart disease in Han Chinese population. The aim of this review paper is to critically analyze the effect of ApoE gene on the occurrence of coronary heart disease in Han Chinese.
Highlights
Among adult cardiovascular mortality in China, Coronary Artery Disease stands as 2nd prominent cause [1] [2]
Many researches have been published pertaining the influence of ApoE gene polymorphism on coronary artery disease, dyslipidemia and the response of statin in Han Chinese
Further study needs to be done in Han Chinese, with large number of sample size and with the same class of statins in order to confirm the impact of ApoE gene on the therapeutic effect of stain in coronary artery disease
Summary
Among adult cardiovascular mortality in China, Coronary Artery Disease stands as 2nd prominent cause [1] [2]. Since ApoE genotype polymorphism was first defined in patients who had dysbetalipoproteinemia and the effect of ApoE gene polymorphism that is why multiple studies were piloted to find the influence of lipid and subsequently cause coronary artery disease in various racial group Since it is polymorphic in nature, which means there is variation amongst the expression of particular isoform, different prevalence of cardiovascular diseases in different ethnicities. This review would focus on the relationship of ApoE gene polymorphism on Coronary Artery Disease in Han Chinese, specially, Acute Coronary Syndrome, the effect of statins in different alleles of ApoE polymorphism and the mechanism of ApoE gene impacting as a genetic risk factor in the pathophysiology of ischemic heart disease
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