A meta-analysis was undertaken to assess the impact of apolipoprotein E (apo E) alleles (ε2, ε3, and ε4) on coronary disease in 14 published observational studies (9 clinical coronary disease and 5 coronary angiography). In comparison with ε3, the ε4 allele was associated with greater odds for coronary heart disease, and summary estimates of the odds ratios (ORs) and (95% confidence intervals) for both sexes combined were OR=0.98 (0.85-1.14) for ε2 and OR=1.26 (1.13-1.41) for ε4. Separate analyses for men and women showed similar associations. In angiographic studies the relative odds for significant coronary artery disease among both sexes combined was OR=0.76 (0.55-1.05) for ε2 and OR=1.11 (0.88-1.40) for ε4. The overall impression is that ε4 is associated with clinical and coronary disease and that results are similar in men and women.