Risk of left ventricular dysfunction in patients with probable Alzheimer's disease with APOE*4 allele.
van der Cammen TJ., Verschoor CJ., van Loon CP., van Harskamp F., de Koning I., Schudel WJ., Slooter AJ., Van Broeckhoven C., van Duijn CM.
OBJECTIVE:To examine the association between the APOE genotype and cardiovascular disease in Alzheimer's disease (AD) patients. DESIGN:Case register study of 100 consecutive referrals to a Memory Clinic where type of dementia and cardiovascular comorbidity were diagnosed and APOE genotype was determined. SETTING:The Memory Clinic, University Hospital Rotterdam Dijkzigt. PARTICIPANTS:One hundred Memory Clinic patients, 59 to 91 years of age, who attended the Memory Clinic in the period between January 1994 and March 1996. MEASUREMENTS:Relative risk of cardiovascular morbidity in probable AD, based on clinical and ECG findings. RESULTS:The diagnosis of probable AD was more frequent in APOE*4 allele-carrying AD patients. When comparing homozygotes for APOE*4 with homozygotes for APOE*3, a nine-fold increase in prevalence of cardiac ischemia on ECG was found in the former. When grouping parameters of left ventricular dysfunction, the prevalence was 7.2 (95% confidence interval 1.2-42.6) times greater in probable Alzheimer patients with APOE4/4. CONCLUSIONS:In patients with probable AD, APOE*4 is associated with cardiac disease indicative of left ventricular dysfunction.