APOE does not predict poor outcome 1 year after ischemic stroke.
OBJECTIVE
The apolipoprotein E gene (APOE) polymorphism may influence outcome in various forms of brain injury. The association between APOE genotype and long-term ischemic stroke (IS) outcome is controversial. We have examined the effect of stroke risk factors, clinical status at admission and APOE genotype on survival and dependency 1 year after IS.


METHODS
We investigated 496 consecutively subjects with IS. Information concerning risk factors and clinical data were collected prospectively. Functional dependency was estimated with modified Rankin scale (mRS) and defined as a score of 3-5. Each patient was offered a I year follow-up evaluation. APOE genotyping was performed by the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. Multivariate regression models were used to analyse predictors of death and poor outcome (death or dependency) within 1 year after the stroke.


RESULTS
The distribution ofAPOE genotypes was 69% with genotype E3/E3, 18% with genotype F3/ E4, 12% with genotype E2/13 and 1% with genotype F2/14. At year 1, 169 patients (38%) had died and 78 of the survivors (28%) were functionally dependent. The best predictors of death at year 1 were: age over 70 years, congestive heart failure, atrial fibrillation, disturbed consciousness and severe hand paresis. Poor outcome was independently predicted by: age over 70 years, congestive heart failure, pre-stroke mRS> or =3, marked disturbance of consciousness and severe hand paresis.


CONCLUSIONS
We did not find any impact of APOE genotype on mortality or poor outcome 1 year after IS.
Sarzyńska-Długosz
Iwona
I
Second Department of Neurology, Institute Psychiatry and Neurology, Warsaw, Poland. isarzynska@yahoo.co.uk
Gromadzka
Grazyna
G
Barańska-Gieruszczak
Maria
M
Ciesielska
Agnieszka
A
Członkowska
Anna
A
D017677:Age Distribution; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001057:Apolipoproteins E / Q000235:genetics*; D002545:Brain Ischemia / Q000235:genetics* / Q000378:metabolism / Q000401:mortality*; D015897:Comorbidity; D003244:Consciousness Disorders / Q000453:epidemiology; D005260:Female; D005787:Gene Frequency; D020022:Genetic Predisposition to Disease / Q000235:genetics*; D005820:Genetic Testing; D005838:Genotype; D006333:Heart Failure / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010291:Paresis / Q000453:epidemiology; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D020521:Stroke / Q000235:genetics* / Q000378:metabolism / Q000401:mortality*; D015996:Survival Rate; D013997:Time Factors
D001057:Apolipoproteins E