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The apolipoprotein E epsilon4 haplotype is an important predictor for recurrence in ischemic cerebrovascular disease
Joong-Seok Kim1, Si-Ryung Han, Sung-Woo Chung
1Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul, South Korea
Insights
The apolipoprotein E (APOE) epsilon4 allele significantly increases the risk of recurrent ischemic cerebrovascular disease (ICVD). Identifying carriers can help predict high-risk patients for targeted prevention strategies.
Area of Science:
- Neurology
- Genetics
- Cardiovascular Science
Background:
- Apolipoprotein E (APOE) plays a role in atherosclerosis.
- The APOE epsilon4 allele is linked to increased risk of Alzheimer's disease, atherosclerosis, ischemic heart disease, and ICVD.
- APOE epsilon4 carriers exhibit higher cholesterol levels.
Purpose of the Study:
- To investigate if a specific apolipoprotein E (APOE) allele predicts ischemic cerebrovascular disease (ICVD).
Main Methods:
- A prospective, longitudinal study was conducted on patients diagnosed with ICVD.
- Patients were recruited from St. Mary Hospital, Korea.
- APOE genotypes were determined, and ICVD was assessed via interviews, medical records, and neuroimaging.
Main Results:
- The 3-year cumulative recurrence rate for ICVD was 22% among 91 patients.
- APOE epsilon4 carriers had a 53% recurrence rate, compared to 16% for non-epsilon4 carriers.
- The risk ratio for recurrence in epsilon4 carriers was 4.11 (95% CI: 1.49-11.32, P<0.01).
Conclusions:
- APOE genotype can identify ICVD patients at high risk for recurrence.
- This finding may aid in developing clinical strategies for ICVD prevention.
Objective:
To determine whether a specific apolipoprotein E (APOE) allele is a predictor for ischemic cerebrovascular disease (ICVD).
Background:
The role of APOE in atherosclerosis has been a focus of intensive research. The APOE epsilon4 allele is overrepresented in Alzheimer's disease, atherosclerosis, ischemic heart disease, and ICVD. Also, epsilon4 carriers have higher cholesterol levels than non-epsilon4 carriers.
Methods:
We performed a prospective, longitudinal study on patients who have ICVD. The patients were recruited from St. Mary Hospital, Korea, and investigated for ICVD through interviews and by reviewing their medical records and neuroimaging studies. APOE genotypes were determined for each patient.
Results:
20 of the 91 enrolled patients had recurrent ICVD, yielding a 3-year cumulative recurrence rate of 22%. Carriers of the epsilon4 allele had a 3-year recurrence rate of 53%, as compared with only 16% for patients who had the APOE non-epsilon4 allele (the risk ratio was 4.11; the 95% CI was 1.49-11.32; P<0.01).
Conclusions:
Our results make possible the identification of patients with ICVD who are at high risk for recurrence by assessing their APOE genotype. Also, this data might be clinically useful in methods for assessing potential strategies for prevention.