APOE does not predict poor outcome 1 year after ischemic stroke

Area of Science:

• Neurology
• Genetics
• Cardiovascular Medicine

Background:

• The apolipoprotein E gene (APOE) polymorphism's role in brain injury outcomes, particularly long-term ischemic stroke (IS) prognosis, remains debated.
• Understanding factors influencing survival and dependency after IS is crucial for patient management.

Purpose of the Study:

• To investigate the influence of APOE genotype, stroke risk factors, and clinical status on survival and functional dependency 1 year after ischemic stroke.
• To clarify the controversial association between APOE genotype and long-term IS outcomes.

Main Methods:

• A prospective study of 496 ischemic stroke patients.
• Data collection included risk factors, clinical status, and 1-year follow-up for survival and functional dependency (modified Rankin scale score 3-5).
• APOE genotyping was performed using PCR-RFLP, and multivariate regression models analyzed predictors of death and poor outcome.

Main Results:

• At 1 year, 38% of patients had died, and 28% of survivors were functionally dependent.
• Predictors of 1-year mortality included advanced age (>70 years), congestive heart failure, atrial fibrillation, disturbed consciousness, and severe hand paresis.
• Poor outcome was independently predicted by age (>70 years), congestive heart failure, pre-stroke dependency (mRS ≥3), significant consciousness disturbance, and severe hand paresis.

Conclusions:

• APOE genotype did not demonstrate a significant impact on mortality or poor functional outcome 1 year following ischemic stroke.
• Factors such as age, comorbidities (congestive heart failure, atrial fibrillation), and initial stroke severity were identified as key predictors of long-term IS outcomes.