Apolipoprotein A2 Isoforms in Relation to the Risk of Myocardial Infarction: A Nested Case-Control Analysis in the JPHC Study

J Atheroscler Thromb. 2021 May 1;28(5):483-490. doi: 10.5551/jat.56218. Epub 2020 Aug 29.


Aim: The fact that low concentrations of high-density lipoprotein cholesterol are associated with the risk of cardiovascular disease is well known, but high-density lipoprotein metabolism has not been fully understood. Apolipoprotein A2 (ApoA2) is the second-most dominant apolipoprotein of high-density lipoprotein. We tested the hypothesis that ApoA2 isoforms are inversely associated with myocardial infarction.

Methods: We measured the plasma levels of three ApoA2 isoforms (ApoA2-ATQ/ATQ, ApoA2-ATQ/AT, ApoA2-AT/AT) in nested case-control study samples of 1:2 from the Japan Public Health-Center-based Study (JPHC Study): 106 myocardial infarction incidence cases and 212 controls.

Results: ApoA2-AT/AT was inversely associated with risk of myocardial infarction, in a matched model (OR, 2.78; 95% CI, 1.26-6.09 for lowest compared with the highest quartile), but its association was attenuated after adjustment for smoking only (OR=2.13; 95% CI, 0.91-4.97) or drinking only (OR=2.11; 0.91-4.89), and the multivariable OR was 1.20 (95% CI, 0.41-3.57). Neither ApoA2-ATQ/ATQ nor ApoA2-ATQ/AT was associated with the risk of myocardial infarction.

Conclusions: Our nested case-control study did not show a significant association of ApoA2 isoforms with a risk of myocardial infarction.

Keywords: Apolipoprotein A-II; Atherosclerosis; C-terminus; Coronary heart disease; HDL.

MeSH terms

  • Apolipoprotein A-II / blood*
  • Case-Control Studies
  • Cohort Studies
  • Female
  • Humans
  • Incidence
  • Japan
  • Male
  • Middle Aged
  • Myocardial Infarction / blood*
  • Myocardial Infarction / diagnosis
  • Myocardial Infarction / epidemiology*
  • Protein Isoforms / blood
  • Risk Factors


  • APOA2 protein, human
  • Apolipoprotein A-II
  • Protein Isoforms