4.6 Article

Association between Apolipoprotein E genotype and functional outcome in acute ischemic stroke

Journal

AGING-US
Volume 15, Issue 1, Pages 108-118

Publisher

IMPACT JOURNALS LLC

Keywords

Apolipoprotein E; stroke; neutrophil-to-lymphocyte ratio; functional outcome

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This study investigates the impact of APOE alleles on the functional outcome in acute ischemic stroke (AIS) patients. It also explores the relationship between inflammation and stroke-related disability based on APOE genotypes. The results indicate that APOE e4 carriers have a worse functional outcome after AIS compared to non-e4 carriers. Additionally, the study finds that the APOE genotype may modify the relationship between neutrophil-to-lymphocyte ratio (NLR) and 3-month stroke outcome.
This study aims to determine whether APOE alleles would affect the functional outcome in acute ischemic stroke (AIS) and whether the relationship between inflammation and stroke-related disability varies according to APOE genotypes. We retrospectively collected the demographic and clinical data of AIS patients within one week of symptom-onset through medical records review. The primary outcome was dependence or death, defined as modified Rankin scale (mRS) score of 2-6, which was assessed at 3 months. Among 1929 enrolled patients, the prevalence of APOE e4 carriers was 17.73% (342/1929). There were 394 AIS patients (394/1929, 20.43%) showed poor function outcome of 90-day mRS (2-6), of whom 147 (147/342, 42.98%) were APOE e4 carriers and 247 (247/1587, 15.56%) were non -e4 carriers. There was a significant increased probability of poor functional outcome after AIS among APOE e4 carriers versus non -e4 carriers (adjusted-OR 4.62, 95% CI 3.51 to 6.09, P < 0.001). Among e4 carriers, high neutrophil-to-lymphocyte ratio (NLR) was significantly associated with stroke-related disability (Ptrend = 0.035); however, no significant association was observed among non -e4 carriers. Our study showed that the APOE e4 carriers had worse functional outcome after AIS as compared with non -e4 carriers. APOE genotype may modify the relationship between NLR and 3-month stroke outcome.

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