The APOE polymorphism and 1-year outcome in ischemic stroke:: Genotype-gender interaction

Objectives - In human genetic studies an effect of the apolipoprotein E gene (APOE) polymorphism on the risk, course and prognosis in chronic and acute nervous system disorders was established. We aimed to evaluate whether the APOE genotype is related to acute neurological impairments due to ischemic stroke (IS), and to outcomes (up to 1 year) indicated by severe functional disability, dependence in daily living or death. Materials and methods - A total of 657 patients (326 men, 331 women), divided into the three groups: E2 (APOE epsilon 2/epsilon 3 subjects), E3 (APOE epsilon 3/epsilon 3 subjects), and E4 (APOE epsilon 3/epsilon 4 and epsilon 4/epsilon 4 subjects), were analyzed. Results - There was no association between the APOE genotype and baseline clinical characteristics, severity of neurological impairments during acute stroke, and 1-year outcome, when analyzing whole patient population. APOE gene interacted with gender in predicting severity of acute neurological deficit and post-stroke mortality within the period up to 1 year after the IS. Gender-stratified analysis indicated the E4 genotype as a significant independent positive predictor of death within 1 year after stroke incidence in men patients. Conclusion - Ischemic stroke severity and outcome may be affected by complex interactions between gender and genetic factors that warrant further exploration.