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Genetic and lifestyle predictors of ischemic stroke severity and outcome

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Abstract

Background

Different models that include clinical variables and blood markers have been investigated to predict acute ischemic stroke treatment course and recovery.

Aim

The aim of the study was to investigate associations between lipid levels, lifestyle factors, hemostatic (F5, F2, SERPINE1, F13A1, and FGB), and atherogenic (APOA5 and ACE) gene variants and acute ischemic stroke (AIS) severity.

Materials and methods

This study included 250 patients with AIS in which F5, F2, SERPINE1, F13A1, FGB, APOA5, and ACE genotypes were determined. Total cholesterol (TC), high-density cholesterol, low-density cholesterol, and triglycerides concentrations were measured within 24 h of the AIS onset. Examination of the neurological deficit was done using National Institutes of Health Stroke Scale/Score (NIHSS).

Results

APOA5 genotype [TC + CC] was more frequent (P = 0.026) in patients with the NIHSS score ≥ 21. Univariate regression analysis has shown that triglycerides (OR 0.55, 95% CI 0.34–0.91; P = 0.019), obesity (0.28, 95% CI 0.10–0.73; P = 0.010), age (OR 1.08, 95% CI 1.04–1.13; P < 0.001), and APOA5 genotype (TC + CC) (OR 2.40, 95% CI 1.10–5.25; P = 0.034) are significantly associated with a severe stroke. When all variables were included in model age (OR 1.06, 95% CI 1.01–1.11; P = 0.018), obesity (OR 0.25, 95% CI 0.08–0.77; P = 0.016) and APOA5 genotype (TC + CC) (OR 3.26, 95% CI 1.29–8.23; P = 0.012) remained significant for the risk of severe AIS.

Conclusion

APOA5 genotype (TC + CC), age, and obesity could be used as prognostic risk factors for a very severe stroke (NIHSS ≥ 21).

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Authors and Affiliations

  1. Department of Clinical Chemistry, Sestre milosrdnice University Hospital Center, Zagreb, Croatia

    Ivana Celap & Nora Nikolac Gabaj

  2. Department of Neurology, Sestre milosrdnice University Hospital Center, Zagreb, Croatia

    Vida Demarin & Vanja Basic Kes

  3. Department of Medical Laboratory Diagnostics, University Hospital Sveti Duh, Zagreb, Croatia

    Ana-Maria Simundic

  4. Department of Medical Biochemistry and Hematology, Faculty of Pharmacy and Biochemistry, University of Zagreb, Zagreb, Croatia

    Ana-Maria Simundic

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  1. Ivana Celap
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  2. Nora Nikolac Gabaj
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  3. Vida Demarin
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Correspondence to Ivana Celap.

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Sestre milosrdnice University Hospital Center ethics committee approved the study and all participants signed informed consent.

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Celap, I., Nikolac Gabaj, N., Demarin, V. et al. Genetic and lifestyle predictors of ischemic stroke severity and outcome. Neurol Sci 40, 2565–2572 (2019). https://doi.org/10.1007/s10072-019-04006-y

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