APOE does not predict poor outcome 1 year after ischemic stroke.

OBJECTIVES: The apolipoprotein E gene (APOE) polymorphism may influence outcome in various forms of brain injury. The association between APOE genotype and long-term ischemic stroke (IS) outcome is controversial. We have examined the effect of stroke risk factors, clinical status at admission and APOE genotype on survival and dependency 1 year after IS. METHODS: We investigated 496 consecutively subjects with IS. Information concerning risk factors and clinical data were collected prospectively. Functional dependency was estimated with modified Rankin scale (mRS) and defined as a score of 3-5. Each patient was offered a I year follow-up evaluation. APOE genotyping was performed by the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. Multivariate regression models were used to analyse predictors of death and poor outcome (death or dependency) within 1 year after the stroke. RESULTS: The distribution ofAPOE genotypes was 69% with genotype E3/E3, 18% with genotype F3/ E4, 12% with genotype E2/13 and 1% with genotype F2/14. At year 1, 169 patients (38%) had died and 78 of the survivors (28%) were functionally dependent. The best predictors of death at year 1 were: age over 70 years, congestive heart failure, atrial fibrillation, disturbed consciousness and severe hand paresis. Poor outcome was independently predicted by: age over 70 years, congestive heart failure, pre-stroke mRS> or =3, marked disturbance of consciousness and severe hand paresis. CONCLUSION: We did not find any impact of APOE genotype on mortality or poor outcome 1 year after IS.