Association of Angiopoietin-Like 3 and Apolipoprotein B Gene Polymorphisms with Coronary Artery Disease

Background: Coronary artery disease (CAD) as a leading cause of mortality, is highly prevalent in Egypt. While traditional risk factors are well-established, genetic predispositions, particularly in lipid-regulating genes like angiopoietin-like 3 (ANGPTL3) , apolipoprotein B (APOB), are critical determinants of individual susceptibility. This study aimed to evaluate the relationship of ANGPTL3 (rs1748195) ,POB (rs562338) polymorphisms with CAD risk among Egyptian population.Methods: We included 112 subjects in this case-control study: 56 patients with angiographically confirmed CAD, 56 age- sex-matched healthy controls. All participants underwent detailed clinical, biochemical profiling. Genotyping for the two polymorphisms was performed using tetra-primer amplification refractory mutation system polymerase chain reaction (T-ARMS-PCR).Results: Compared to controls, CAD patients exhibited a significantly worse metabolic profile, including higher BMI, fasting blood glucose, HbA1c, total cholesterol, triglycerides, and LDL-C, alongside lower HDL-C (all p<0.001). Multivariate logistic regression identified smoking (OR=2.45, 95% CI: 1.05–5.72, p=0.05) and hypertension (OR=3.12, 95% CI=1.30–7.50, p=0.02) as independent predictors of CAD. A significant association was exhibited between ANGPTL3 rs1748195 GG genotype with CAD, which was an independent risk factor after adjustment (OR=3.26, 95% CI=1.17–9.13, p=0.03). Conversely, the APOB rs562338 polymorphism demonstrated no significant independent association with CAD risk, severity, or lipid parameters.Conclusion: This study reaffirms the central role of conventional risk factors in CAD among Egyptians. Furthermore, it identifies the ANGPTL3 rs1748195 GG genotype as an independent genetic risk factor, implicating it in the disease's pathogenesis, likely through lipid metabolism pathways. In contrast, the APOB rs562338 variant does not appear to be a major contributor.