APOE genotype and serum cholesterol in predicting risk for early death from ischemic stroke in men and women

Background: We recently discovered that APOE epsilon 3/epsilon 4 genotype in men and APOE epsilon 2/epsilon 3 genotype in women are associated with increased risk of death from ischemic stroke ( IS). One of the main physiological roles of apolipoprotein E is participation in cholesterol metabolism. A significant association of low serum cholesterol level with increased risk of death from stroke was documented. So, we aimed to establish if an association exists between APOE genotype, serum cholesterol and 1-month mortality in IS. Methods: We studied 666 patients ( 330 men, 336 women) with a diagnosis of IS. Total serum cholesterol (TC) was measured with the method of Abbott Spectrum ( USA). APOE genotyping was performed by PCR-RFLP method. Results: The highest frequency of low serum TC was associated with APOE epsilon 2/epsilon 3 genotype ( both in men and in women). Low serum TC was associated with increased mortality rate only in women; this effect was evident only in females not possessing APOE epsilon 2/epsilon 3. Female patients with APOE epsilon 2/epsilon 3 genotype had high 1-month mortality rate independently from serum TC. In multiple regression analyses APOE epsilon 3/epsilon 4 genotype in men and APOE epsilon 2/epsilon 3 genotype in women predicted risk of death independently from serum TC and also from other potential pre- and post-stroke prognostic factors. Conclusion: APOE epsilon 3/epsilon 4 genotype in men and APOE epsilon 2/epsilon 3 in women are associated with increased 30-day mortality in stroke. This effect seems be independent from serum cholesterol. Copyright (C) 2005 S. Karger AG, Basel.