Neurology®
The most widely read and highly cited peer-reviewed Neurology journal
Quick Search
Advanced Search
Published online before print February 6, 2008, doi:10.1212/01.wnl.0000308819.43401.87)
This Article
Right arrow Full Text (Rapid PDF)
Right arrow CME: Take the course for this article:
 Volume 70, Number 16, April 15, 2008
Right arrow All Versions of this Article:
01.wnl.0000308819.43401.87v1
70/16/1322    most recent
Right arrow Correspondence:
Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when Correspondence are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrowRequest Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Tzourio, C.
Right arrow Articles by MacMahon, S.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Tzourio, C.
Right arrow Articles by MacMahon, S.
Received February 11, 2007
Accepted July 2, 2007

APOE genotype, ethnicity, and the risk of cerebral hemorrhage

C. Tzourio MD, PhD*, H. Arima MD, S. Harrap PhD, C. Anderson MD, PhD, O. Godin MSc, M. Woodward PhD, B. Neal PhD, M. -G. Bousser MD, J. Chalmers PhD, F. Cambien MD, PhD, and S. MacMahon PhD

From INSERM U708 (C.T., O.G.), the Department of Neurology, Hôpital Lariboisière (C.T., M.-G.B.), and the Université Pierre et Marie Curie-Paris 6 (C.T., O.G.), Paris, France; The George Institute for International Health (C.T., C.A., M.W., B.N., J.C., S.M.), University of Sydney, Australia; Department of Environmental Medicine (H.A.), Kyushu University, Fukuoka, Japan; Department of Physiology (S.H.), University of Melbourne, Australia; Mt Sinai Medical Center (M.W.), New York, NY; and INSERM U525 (F.C.), Paris, France.


* To whom correspondence should be addressed. E-mail: tzourio{at}chups.jussieu.fr.

Objective: The apolipoprotein E (APOE) polymorphism is an established risk factor for intracerebral hemorrhage (ICH) that is related to cerebral amyloid angiopathy in the white population. Among Asian populations, although ICH represents up to one third of all strokes and has high rates of mortality and morbidity, the role of the APOE polymorphism has not been well studied.

Methods: The Perindopril Protection Against Recurrent Stroke Study (PROGRESS) was a randomized, double-blind, placebo-controlled trial of a blood pressure lowering regimen in subjects with prior cerebrovascular disease. APOE status was determined for 5,671 patients, including 2,148 Asians (38%).

Results: During the 3.9 years of follow-up, ICH occurred in 99 patients. Overall, carrying an {epsilon}2 or {epsilon}4 allele of the APOE polymorphism was associated with an adjusted hazard ratio (HRa) of 1.85 (95% CI = 1.24 to 2.76). In Asian patients the risk of ICH for {epsilon}2 or {epsilon}4 carriers was 2.11 (95% CI = 1.28 to 3.47) and 1.48 (95% CI = 0.76 to 2.87) in Europeans. Carriers of the {epsilon}2 or {epsilon}4 allele had an increased risk of both incident and recurrent ICH, and both cortical and deep ICH, and most risk estimates were higher in Asians than in Europeans. For both ethnic groups and for subtypes of ICH active treatment more than halved the risk of ICH and the treatment effects were not different in carriers of the {epsilon}2 or {epsilon}4 allele and in those with the {epsilon}3{epsilon}3 genotype.

Conclusions: There is a strong association between APOE genotype and the risk of intracerebral hemorrhage (ICH). In Asian patients the role of APOE polymorphisms in ICH is much broader than was previously supposed.




This article has been cited by other articles:


Home page
 StrokeHome page
H. Arima, C. Tzourio, C. Anderson, M. Woodward, M.-G. Bousser, S. MacMahon, B. Neal, J. Chalmers, and for the PROGRESS Collaborative Group
Effects of Perindopril-Based Lowering of Blood Pressure on Intracerebral Hemorrhage Related to Amyloid Angiopathy: The PROGRESS Trial
Stroke, February 1, 2010; 41(2): 394 - 396.
[Abstract] [Full Text] [PDF]

Home page
 StrokeHome page
M. L. James, P. M. Sullivan, C. D. Lascola, M. P. Vitek, and D. T. Laskowitz
Pharmacogenomic Effects of Apolipoprotein E on Intracerebral Hemorrhage
Stroke, February 1, 2009; 40(2): 632 - 639.
[Abstract] [Full Text] [PDF]

Home page
 StrokeHome page
M. H. Eckman, L. K.S. Wong, Y. O.Y. Soo, W. Lam, S. R. Yang, S. M. Greenberg, and J. Rosand
Patient-Specific Decision-Making for Warfarin Therapy in Nonvalvular Atrial Fibrillation: How Will Screening With Genetics and Imaging Help? * Supplemental Appendix
Stroke, December 1, 2008; 39(12): 3308 - 3315.
[Abstract] [Full Text] [PDF]