Apolipoprotein E (APOE) Gene Polymorphisms in Libyan Patients with Coronary Heart Disease: A Pilot Descriptive Study with Methodological Considerations for Future Research

Abstract Objective This pilot descriptive study aimed to investigate APOE genotype frequencies among Libyan patients with coronary heart disease (CHD), examine associations with clinical characteristics, identify methodological challenges, and provide feasibility data for future research. Given the absence of genetic data from North African populations, including Libya, this study represents an initial investigation of APOE polymorphisms in this population. Results Among 60 CHD patients (60.0% female, mean age 63.98 years), ε2/ε4 was the most prevalent genotype (45.0%), followed by ε3/ε4 (30.0%), ε2/ε3 (16.7%), and ε3/ε3 (8.3%). ε4-containing genotypes accounted for 75.0% of patients. A significant association between smoking status and APOE genotype was observed among male patients (p = 0.001), though based on a small subgroup (n = 24). Most patients (60.0%) had normal lipid profiles due to lipid-lowering therapy. A validation subset (n = 28) revealed only 34.8% concordance between the strip assay and real-time PCR (κ = 0.19), indicating substantial methodological challenges. The absence of a matched control group means these findings require confirmation in larger, adequately powered case-control studies with standardized genotyping protocols and orthogonal validation.