Association of coronary artery disease with toll-likereceptor 4 genetic variants: A meta-analysis

BACKGROUND: Toll-like receptor 4 (TLR4) plays an important role in the formation of coronary atherosclerotic plaque and the pathogenesis of coronary artery disease (CAD). OBJECTIVES: The aim of the study was to conduct a meta-analysis assessing the relationship between 2 common genetic variants in the TLR4 gene (rs4986790 and rs4986791) and susceptibility to CAD. MATERIAL AND METHODS: A systematic search of Web of Science, Embase, Scopus, PubMed, and Wanfang Med Online was undertaken. Case-control studies assessing the association of rs4986790 and rs4986791 with CAD risk were included. The odds ratio (OR) and 95% confidence interval (CI) were used as the metric of choice for the evaluation of risk. RESULTS: The literature search generated 427 studies, of which 14 met the inclusion criteria, for a total of 13,927 participants. Our meta-analysis revealed a significant association between rs4986791 and CAD risk in Asians using the dominant model (CT + TT vs CC: OR = 0.35, 95% CI = 0.21-0.56, p < 0.001), heterozygote contrast (CT vs CC: OR = 0.32, 95% CI = 0.19-0.57, p < 0.001) and allele contrast (T vs C: OR = 0.38, 95% CI = 0.25- 0.58, p < 0.001). No significant association between rs4986791 and CAD was observed among Caucasians. For rs4986790, the results provided no evidence of an association with CAD risk. CONCLUSIONS: Our analysis suggests that rs4986791 is negatively associated with CAD risk in Asians but not in Caucasians. No association between rs4986790 and CAD risk was found.