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Published online before print February 6, 2008, doi:10.1212/01.wnl.0000308819.43401.87)
Accepted July 2, 2007 APOE genotype, ethnicity, and the risk of cerebral hemorrhageC. Tzourio MD, 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 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.
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