The apolipoprotein E epsilon4 haplotype is an important predictor for recurrence in ischemic cerebrovascular disease.
OBJECTIVE
To determine whether a specific apolipoprotein E (APOE) allele is a predictor for ischemic cerebrovascular disease (ICVD).


BACKGROUND
The role of APOE in atherosclerosis has been a focus of intensive research. The APOE epsilon4 allele is overrepresented in Alzheimer's disease, atherosclerosis, ischemic heart disease, and ICVD. Also, epsilon4 carriers have higher cholesterol levels than non-epsilon4 carriers.


METHODS
We performed a prospective, longitudinal study on patients who have ICVD. The patients were recruited from St. Mary Hospital, Korea, and investigated for ICVD through interviews and by reviewing their medical records and neuroimaging studies. APOE genotypes were determined for each patient.


RESULTS
20 of the 91 enrolled patients had recurrent ICVD, yielding a 3-year cumulative recurrence rate of 22%. Carriers of the epsilon4 allele had a 3-year recurrence rate of 53%, as compared with only 16% for patients who had the APOE non-epsilon4 allele (the risk ratio was 4.11; the 95% CI was 1.49-11.32; P<0.01).


CONCLUSIONS
Our results make possible the identification of patients with ICVD who are at high risk for recurrence by assessing their APOE genotype. Also, this data might be clinically useful in methods for assessing potential strategies for prevention.
Kim
Joong-Seok
JS
Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul, South Korea
Han
Si-Ryung
SR
Chung
Sung-Woo
SW
Kim
Beum-Saeng
BS
Lee
Kwang-Soo
KS
Kim
Yeong-In
YI
Yang
Dong-Won
DW
Kim
Kwang-Soo
KS
Kim
Jong-Won
JW
D000368:Aged; D053327:Apolipoprotein E4; D001057:Apolipoproteins E / Q000235:genetics*; D001161:Arteriosclerosis / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D002545:Brain Ischemia / Q000097:blood*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006239:Haplotypes; D006801:Humans; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D011237:Predictive Value of Tests; D012008:Recurrence; D013997:Time Factors
D053327:Apolipoprotein E4; D001057:Apolipoproteins E; D015415:Biomarkers