ArticleAssociation between apolipoprotein E4 and rehabilitation outcome in hospitalized ischemic stroke patients 1
Section snippets
Participants
The study included consecutive patients aged 75 years or less who were referred to the neurologic rehabilitation department of Loewenstein Rehabilitation Center (LRC) after an ischemic stroke. The LRC is an academic institution that accepts patients from throughout Israel. Demographic and clinical data were collected prospectively. All patients were studied using brain imaging techniques, computed tomography scan, or magnetic resonance imaging to determine the precise place of brain damage. For
Results
There was a trend for an increased severity of stroke on admission in the 35 patients who had the APOE∗E4 allele (table 1). This finding was nearly significant for aphasia, which was twice as frequent in patients with the allele (95% CI, 0.98–4.40).
On univariate analysis, the APOE∗E4 allele did not predict poor neurologic status at discharge, as measured by the NIHSS. Both the FIM and the NIHSS were strongly associated with this outcome measure (table 2). A logistic regression model was
Discussion
The major finding of our study is that, among hospitalized patients aged 75 years or less with a first ischemic stroke, the presence of the APOE∗E4 genotype did not negatively affect recovery during rehabilitation. Our findings are consistent with those of previous studies, which also found that the presence of an APOE∗E4 genotype in 640 patients with an ischemic stroke did not predict recovery at 3 months,26 subsequent work ability at 11 months in 234 patients,12 or poorer functional status
Conclusion
Our results should be interpreted with caution. Ours was a prospective observational study of a specific population of patients with stroke, and the test results were obtained only after rehabilitation was completed. However, LRC’s admission criteria are very liberal, so our results can probably be extrapolated to other ischemic stroke patients who survive the first week, who are conscious, and who do not need a respirator. Furthermore, personnel who did the testing were blinded to the
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