The APOE polymorphism and 1-year outcome in ischemic stroke: genotype-gender interaction.
OBJECTIVE
In human genetic studies an effect of the apolipoprotein E gene (APOE) polymorphism on the risk, course and prognosis in chronic and acute nervous system disorders was established. We aimed to evaluate whether the APOE genotype is related to acute neurological impairments due to ischemic stroke (IS), and to outcomes (up to 1 year) indicated by severe functional disability, dependence in daily living or death.


METHODS
A total of 657 patients (326 men, 331 women), divided into the three groups: E2 (APOEepsilon2/epsilon3 subjects), E3 (APOEepsilon3/epsilon3 subjects), and E4 (APOEepsilon3/epsilon4 and epsilon4/epsilon4 subjects), were analyzed.


RESULTS
There was no association between the APOE genotype and baseline clinical characteristics, severity of neurological impairments during acute stroke, and 1-year outcome, when analyzing whole patient population. APOE gene interacted with gender in predicting severity of acute neurological deficit and post-stroke mortality within the period up to 1 year after the IS. Gender-stratified analysis indicated the E4 genotype as a significant independent positive predictor of death within 1 year after stroke incidence in men patients.


CONCLUSIONS
Ischemic stroke severity and outcome may be affected by complex interactions between gender and genetic factors that warrant further exploration.
Gromadzka
G
G
Second Department of Neurology, Institute of Psychiatry and Neurology, Sobieskiego 9, Warsaw, Poland.
Baranska-Gieruszczak
M
M
Sarzynska-Dlugosz
I
I
Ciesielska
A
A
Czlonkowska
A
A
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D053327:Apolipoprotein E4 / Q000235:genetics; D001057:Apolipoproteins E / Q000235:genetics*; D002545:Brain Ischemia / Q000453:epidemiology / Q000235:genetics* / Q000503:physiopathology; D004252:DNA Mutational Analysis; D004185:Disability Evaluation; D005260:Female; D005819:Genetic Markers / Q000235:genetics; D020022:Genetic Predisposition to Disease / Q000235:genetics*; D005820:Genetic Testing; D005838:Genotype; D006801:Humans; D008297:Male; D008875:Middle Aged; D011110:Polymorphism, Genetic / Q000235:genetics*; D011237:Predictive Value of Tests; D011379:Prognosis; D020033:Protein Isoforms / Q000235:genetics; D012680:Sensitivity and Specificity; D012727:Sex Characteristics; D012737:Sex Factors; D020521:Stroke / Q000453:epidemiology / Q000235:genetics* / Q000503:physiopathology
D053327:Apolipoprotein E4; D001057:Apolipoproteins E; D005819:Genetic Markers; D020033:Protein Isoforms