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Apolipoprotein E genotype, coagulation, and survival following acute stroke

From the Acute Stroke Unit (Drs. Weir, Dyker, and Lees), Department of Medicine and Therapeutics, Gardiner Institute, Western Infirmary; and Departments of Neurology (Drs. McCarron, Muir, and Bone) and Neuropathology (Drs. McCarron and Nicoll), Institute of Neurological Sciences, Southern General Hospital, Glasgow, Scotland.

Address correspondence and reprint requests to Dr. C.J. Weir, Department of Medicine and Therapeutics, Gardiner Institute, Western Infirmary, Glasgow, G11 6NT, Scotland, UK; e-mail: C.J.Weir{at}clinmed.gla.ac.uk

Article abstract—— The authors hypothesized that divergent influences of the APOE 4 allele on ischemic and hemorrhagic stroke survival might result from differences in coagulation profiles. In 49 hemorrhagic stroke patients, 4 carriers had higher partial thromboplastin time ratios (p < 0.01) than non-4 carriers. Among 529 ischemic stroke patients, increasing 4 allele dose was associated with improved survival (p = 0.03) after adjusting for baseline NIH stroke scale (p = 0.00001) and partial thromboplastin time ratio (p = 0.01). Relative anticoagulation does not fully explain the survival advantage in 4-carrying ischemic stroke patients.

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