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

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.

Automated summary

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.