Prospective study of apolipoprotein E genotype and functional outcome following ischemic stroke.

Abstract

BACKGROUND:

The apolipoprotein E (APOE) epsilon 4 allele is a marker of adverse outcome following head injury and intracerebral hemorrhage. Transgenic animal data in a focal cerebral ischemia model suggest that the epsilon 4 allele increases infarct size and functional impairment.

OBJECTIVE:

To determine if APOE genotype is associated with functional recovery from ischemic stroke.

DESIGN:

Prospective study.

SETTING:

Stroke service at a university teaching hospital.

PATIENTS:

Patients with clinical and neuroimaging findings (computed tomography or magnetic resonance imaging) compatible with an acute ischemic stroke.

MAIN OUTCOME:

Functional outcome by Barthel index (BI) and modified Rankin scale (mRS) was compared for epsilon 3/epsilon 3 patients vs epsilon 4 carriers and vs epsilon 2 carriers at 1 and 3 months. Univariate predictors of 3-month outcome were examined in a multivariate analysis.

RESULTS:

One hundred eighty nine patients were enrolled: 100 women, 89 men (mean +/- SD age, 69.4 +/- 11.0 years). There were 25 epsilon 2 alleles (frequency, 0.07), 292 epsilon 3 alleles (0.77), and 61 epsilon 4 alleles (0.16). Baseline National Institutes of Health Stroke Scale scores and Oxfordshire Community Stroke Project classifications were similar in all groups (epsilon 3/epsilon 3, epsilon 4, and epsilon 2 carriers). One-month (BI, P = .64; mRS, P = .59) and 3-month (BI, P = .87; mRS, P = .73) outcomes were not associated with possession of either epsilon 4 or the epsilon 2 allele. Baseline National Institutes of Health Stroke Scale scores (P < .001) and age (P = .002) were significant predictors of 3-month BI and mRS outcomes in multivariate analyses.

CONCLUSIONS:

Although there is a robust influence of APOE polymorphism on functional recovery after some types of brain injury in humans, it does not exert a major influence on injury severity or functional recovery following ischemic stroke. Arch Neurol. 2000;57:1480-1484

• Authors: M O McCarron, K W Muir, J A Nicoll, J Stewart, Y Currie, K Brown, I Bone
• Journal: Archives of neurology (Arch Neurol) Vol. 57 Issue 10 Pg. 1480-4 (Oct 2000) ISSN: 0003-9942 [Print] United States
• PMID: 11030801 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Apolipoproteins E

Topics

• Adult
• Aged
• Aged, 80 and over
• Apolipoproteins E (genetics, metabolism)
• Brain (diagnostic imaging, metabolism, pathology)
• Female
• Genotype
• Humans
• Magnetic Resonance Imaging
• Male
• Middle Aged
• Prospective Studies
• Recovery of Function
• Severity of Illness Index
• Stroke (diagnosis, metabolism, physiopathology)
• Tomography, X-Ray Computed