Apolipprotein e polymorphism in cerbrovascular disease

7- SUMMARYIntroduction and Objectives: Atherosclerosis is an important risk factor forstroke and apolipoprotein E (apo E) polimorphism is one of the genetic factors thatplays a role in the pathogenesis of atherosclerosis. Currently, the exact relationshipbetween Apo E genotype and stroke is unknown.The objectives of this study are to; a) investigate the relationship between apoE genotype, acute cerebral infarction and intracerebral hemorrhage, b) establish arelationship between apo E genotype and risk factors for cerebrovascular disease, c)investigate the relationship betweeen acute stroke mortality and apo E genotype, d)establish a relationship between apo E genotype and primary preventive therapy.Method: 100 hospitalized patients who were diagnosed clinically andradiologically as acute ischemic or hemorrhagic stroke and 30 healthy subjects in thesame age group were chosen for this study. Cranial CT or MRI was performed todetermine the stroke phenotype (cerebral infarction, CI or intracranial hemorrhage,ICH) in the first 10 days after the acute event. The patients with cerebral infarctionwere classified according to the Oxfordshire Community Stroke Project (OCSP)Classification (OCSP). Intracranial hemorrhages were classified according to thelocation of the lesions. Allel analysis was performed to determine the allel type of thepatients by using the `?High Pure PCR Template Preparation Kit??, ?Light Cycler-ApoE Mutation Detection Kit (codon 112 and 158)`?, ?Light Cycler-Red 640 and LightCycler-Red 705 marked probes?. Detailed neurologic and systemic examinations ofall the patients and the healthy subjects under the study were performed as well asroutine laboratuary examinations (complete blood count, electrolytes, blood glucose,lipids and other parameters), total apo E, electrocardiography (ECG), chestradiography, and echocardiography.75Results: There was a statistically significant difference in LDL-Cholesterol,Total Cholesterol and LVH variables between the stroke patients and the healthycontrol group (p<0.05).During the study, 24 out of 100 stroke patients (24%) died while on treatmentin the hospital. The avarage period for patient deaths were 4.1± 1.2 days. There wasa statistically significant difference (p<0.05) in Sis-Ta, history of ischemic heartdisease and LDL-c variables between the stroke patients who survived and thepatients who did not survive.While studying apo E genotype of stroke patients and variables, a significantcorrelation was found between VLDL-e24, Dias-TA-e34 ,Total Cholesterol e34,e44and atherom plaques-e34,e44 in carotis arteries.The relationship between Apo E genotypes with OCSP subtypes of cerebralinfarction and intracranial hemorrhage was not statistically significant (p>0.05).Conlusion: 1- There was no statistically significant relation between ischemicand hemorrhogic stroke and apo E genotype polimorphism as a risk factor.2-There was no significant finding to establish a relationshipbetween pathogenesis of all kinds of mortalities after acute stroke and apo Egenotype polimorphism.Key Words: Apolipoprotein E; cerebrovascular disease; Apo E genotype; riskfactors; mortality.76