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Apolipoprotein E polymorphism in aneurysmal subarachnoid haemorrhage in West Sweden
Author(s) -
Csajbok L. Z.,
Nylén K.,
Öst M.,
Blennow K.,
Zetterberg H.,
Nellgård P.,
Nellgård B.
Publication year - 2016
Publication title -
acta neurologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.967
H-Index - 95
eISSN - 1600-0404
pISSN - 0001-6314
DOI - 10.1111/ane.12487
Subject(s) - apolipoprotein e , medicine , subarachnoid hemorrhage , glasgow outcome scale , glasgow coma scale , genotype , allele , stroke (engine) , surgery , disease , biology , genetics , mechanical engineering , engineering , gene
Background and purpose Aneurysmal subarachnoid haemorrhage ( aSAH ) is associated with high morbidity and mortality despite novel treatments. Genetic variability may explain outcome differences. Apolipoprotein E (ApoE) is a glycoprotein with a major role in brain lipoprotein metabolism. It has three isoforms encoded by distinct alleles: APOE ε2, APOE ε3 and APOE ε4 . The APOE ε4 allele is associated with Alzheimer's disease and worse outcome after traumatic brain injury and ischaemic stroke. This prospective blinded study explored the influence of the APOE ε4 polymorphism on the risk of aSAH , risk of cerebral vasospasm ( CVS ) and 1‐year neurological outcome. Methods The APO Εε4 polymorphism was analysed in 147 patients with aSAH . Allele and genotype frequencies were compared to those found in a gender‐ and area‐matched control group of healthy individuals ( n = 211). Early CVS was identified and treated according to neurointensive care unit ( NICU ) guidelines. Neurological deficit(s) at admittance and at 1‐year follow‐up visit was recorded. Neurological outcome was assessed by the National Institute of Health Stroke Scale, Barthel Index and the Extended Glasgow Outcome Scale. Results APOE ε4 and non‐ APOE ε4 allele frequencies were similar in aSAH patients and healthy individuals. The presence of APOE ε4 was not associated with the development of early CVS . We could not find an influence of the APOE polymorphism on 1‐year neurological outcome between groups. Subgroup analyses of patients treated with surgical clipping vs endovascular coiling did not reveal any associations. Conclusions The APOE ε4 polymorphism has no major influence on risk of aSAH , the occurrence of CVS or long‐term neurological outcome after aSAH .