Effect of apoE genotype on the hypolipidaemic response to pravastatin in an outpatient setting

Abstract. Pena R, Lahoz C, Mostaza JM, Jimenez J, Subirats E, Pinto X, Taboada M, Lopez-Pastor A, The RAP study group (Hospital Carlos III; Instituto de Salud Carlos III, Madrid; Hospital de Puigcerda, Gerona; Hospital de Bellvitge, Barcelona; Centro de Salud de Fuencarral; Hospital La Paz, Madrid, Spain). Effect of apoE genotype on the hypolipidaemic response to pravastatin in an outpatient setting. J Intern Med 2002; 251: 518–525. Background. Considerable variability exists in the plasma lipid and lipoprotein response to statin treatment due, in part, to genetic factors. The gene for apolipoprotein E (ApoE) is polymorphic and the different genotypes modulate baseline lipid levels. The objective of the present study was to evaluate the effect of the apoE genotype on the lipoprotein response to pravastatin treatment in an outpatient population followed-up in several different clinics across Spain. Subjects and methods. Subjects (n=401; 56% female; mean age 57 years), who were hypercholesterolaemic despite a diet poor in saturated fat and cholesterol, were treated according to NCEP-ATP II guidelines. Plasma lipids and lipoproteins were measured centrally before and after 16 weeks of treatment with 20 mg day−1 of pravastatin. Results. ApoE genotype distributions were 3.2% with ɛ2/3, 73.1% with ɛ3/3 and 22.4% with ɛ3/4 or ɛ4/4. ApoE genotype did not have any effect on baseline lipid levels except on triglycerides such that the carriers of the ɛ2 allele had concentrations significantly greater than those subjects with ɛ3/3 genotype and carriers of the ɛ4 allele after adjustment for age, gender and body mass index (BMI) (P < 0.001). Once adjusted for age, gender, BMI and baseline lipid levels, the apoE polymorphism did not significantly influence the plasma lipid and lipoprotein response to pravastatin. Conclusion. ApoE genotype appears not to influence the hypolipidaemic effect of pravastatin in patients monitored in a general outpatient setting.