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A systematic review and meta-analysis of 130,000 individuals shows smoking does not modify the association of APOE genotype on risk of coronary heart disease

Holmes, Michael V and Frikke-Schmidt, Ruth and Melis, Daniela and Luben, Robert and Asselbergs, Folkert W and Boer, Jolanda MA and Cooper, Jackie and Palmen, Jutta and Horvat, Pia and Engmann, Jorgen and Li, Ka-Wah and Onland-Moret, N Charlotte and Hofker, Marten H and Kumari, Meena and Keating, Brendan J and Hubacek, Jaroslav A and Adamkova, Vera and Kubinova, Ruzena and Bobak, Martin and Khaw, Kay-Tee and Nordestgaard, Børge G and Wareham, Nick and Humphries, Steve E and Langenberg, Claudia and Tybjaerg-Hansen, Anne and Talmud, Philippa J (2014) 'A systematic review and meta-analysis of 130,000 individuals shows smoking does not modify the association of APOE genotype on risk of coronary heart disease.' Atherosclerosis, 237 (1). pp. 5-12. ISSN 0021-9150

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Abstract

Background: Conflicting evidence exists on whether smoking acts as an effect modifier of the association between APOE genotype and risk of coronary heart disease (CHD). Methods and results: We searched PubMed and EMBASE to June 11, 2013 for published studies reporting APOE genotype, smoking status and CHD events and added unpublished data from population cohorts. We tested for presence of effect modification by smoking status in the relationship between APOE genotype and risk of CHD using likelihood ratio test.In total 13 studies (including unpublished data from eight cohorts) with 10,134 CHD events in 130,004 individuals of European descent were identified. The odds ratio (OR) for CHD risk from APOE genotype (ε4 carriers versus non-carriers) was 1.06 (95% confidence interval (CI): 1.01, 1.12) and for smoking (present vs. past/never smokers) was OR 2.05 (95%CI: 1.95, 2.14). When the association between APOE genotype and CHD was stratified by smoking status, compared to non-ε4 carriers, ε4 carriers had an OR of 1.11 (95%CI: 1.02, 1.21) in 28,789 present smokers and an OR of 1.04 (95%CI 0.98, 1.10) in 101,215 previous/never smokers, with no evidence of effect modification (. P-value for heterogeneity=0.19). Analysis of pack years in individual participant data of >60,000 with adjustment for cardiovascular traits also failed to identify evidence of effect modification. Conclusions: In the largest analysis to date, we identified no evidence for effect modification by smoking status in the association between APOE genotype and risk of CHD.

Item Type: Article
Uncontrolled Keywords: APOE genotype; Smoking; Coronary heart disease; Gene-environment interaction
Subjects: H Social Sciences > H Social Sciences (General)
R Medicine > R Medicine (General)
Divisions: Faculty of Social Sciences
Faculty of Social Sciences > Institute for Social and Economic Research
SWORD Depositor: Elements
Depositing User: Elements
Date Deposited: 06 Feb 2015 11:42
Last Modified: 15 Jan 2022 00:42
URI: http://repository.essex.ac.uk/id/eprint/12657

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