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

Area of Science:

• Neurology
• Genetics
• Immunology

Background:

• The apolipoprotein E (APOE) gene is implicated in various neurological conditions.
• Understanding APOE's role in acute ischemic stroke (AIS) can refine prognostic assessments.
• Inflammation plays a critical role in stroke pathophysiology and recovery.

Purpose of the Study:

• To investigate the impact of APOE alleles on functional outcomes in AIS patients.
• To determine if APOE genotype modifies the relationship between inflammation and stroke-related disability.

Main Methods:

• Retrospective analysis of demographic and clinical data from 1929 AIS patients.
• Assessment of functional outcome at 3 months using the modified Rankin scale (mRS) score (2-6 for dependence or death).
• Evaluation of APOE ε4 carrier status and neutrophil-to-lymphocyte ratio (NLR) in relation to outcomes.

Main Results:

• APOE ε4 carriers (17.73%) had a significantly increased probability of poor functional outcome (adjusted OR 4.62, P < 0.001).
• Among APOE ε4 carriers, high NLR was associated with stroke-related disability (Ptrend = 0.035), but not in non-ε4 carriers.
• Poor functional outcome (mRS 2-6) was observed in 20.43% of all patients.

Conclusions:

• APOE ε4 carriage is a significant risk factor for worse functional outcomes following AIS.
• APOE genotype may modulate the association between inflammatory markers (NLR) and long-term stroke-related disability.
• These findings highlight the importance of genetic factors in predicting stroke recovery.