LDLR, ApoB and ApoE genes polymorphisms and classical risk factors in premature coronary artery disease

• LDLR A + A + genotypes may increase the susceptibility of an individual to have PCAD.
• ApoB X + allele may increase the susceptibility of an individual to have PCAD.
• ApoE E4 allele may increase the susceptibility of an individual to have PCAD.
• Coexistence of CAD risk factors with LDLR, ApoB, ApoE genotypes may be involved in the development of PCAD.

Lipoproteins play a central role in the development of atherosclerotic disease. So, with their ability to affect lipid levels, the LDLR, ApoB and ApoE polymorphisms could be one of the factors influencing development of atherosclerosis. This hypothesis has been tested in different populations with conflicting results. The purpose of the present study was to investigate the association between the LDLR, ApoB and ApoE genes polymorphisms with premature CAD (PCAD) in Egyptians. One hundred thirty-five patients of PCAD and one hundred thirty-two ages and sex matched control subjects were included in the study. LDLR and ApoB genes polymorphisms were analyzed by polymerase chain reaction (PCR). The ApoE genotypes were identified by multiplex amplification refractory mutation system (multi-AMRS). We found that LDLR A + A + genotype, ApoB X + allele and ApoE E4 allele increased the risk of PCAD by 1.8, 2.1 and 12.1 respectively. The present study proved that smoking, metabolic syndrome, ApoB X + X + genotype and ApoE E4 allele were independent risk factors for the development of PCAD. This is the first study investigate the association between low density lipoprotein receptor, apolipoprotein B and apolipoprotein E genes polymorphisms with PCAD and lipid levels in Egyptians and we concluded that the LDLR A + A + genotype, ApoB X + allele and ApoE E4 allele may be associated with an increased risk for development of PCAD by elevated levels of total cholesterol (TC) and low density lipoprotein (LDLc). The coexistence of CAD risk factors with LDLR A + A + genotype, ApoB X + allele and ApoE E4 allele may increase the risk of the development of PCAD in Egyptian patients.