The hypoperfusion intensity ratio associates with APOE gene polymorphism in acute ischemic stroke patients with large vessel occlusion

Determine whether APOE gene polymorphism is associated with hypoperfusion intensity ratio (HIR) in acute ischemic stroke (AIS) patients with large vessel occlusion (LVO). Continuously reviewed hospitalized LVO-AIS patients. According to whether the patients carried APOE allele ε 4, they were divided into 2 groups: ε4 carriers and non-ε4 carriers. CTP assessed HIR and infarct core (IC) volume. Good collaterals were defined as HIR < 0.4 and poor collaterals were defined as HIR ≥ 0.4. The patients were divided into two groups based on their HIR value: the HIR < 0.4 group and the HIR ≥ 0.4 group. IC volume was a rCBF < 40% volume. NIHSS at admission assessed stroke severity. A total of 101 patients with LVO-AIS were enrolled, including 82 patients with HIR < 0.4 and 19 patients with HIR ≥ 0.4. Among the patients with HIR < 0.4, 10 were ε4 carriers (12.20%), while among those with HIR ≥ 0.4, 8 were ε4 carriers (42.11%). The proportion of ε4 carriers was significantly higher in the HIR ≥ 0.4 patients group (P = 0.006). In all enrolled patients, there were 83 non-ε4 carriers and 18 ε4 carriers. The IC volume in ε4 carriers was significantly higher than that in non-ε4 carriers (P = 0.003). The NIHSS score in ε4 carriers was significantly higher than that in non-ε4 carriers (P = 0.004). Binary logistic regression showed that APOE ε4 was an independent risk factor for poor collaterals (OR = 6.00, 95%CI: 1.80, 20.02, P = 0.004). Multiple linear regression showed HIR had a significant positive effect on IC volume (B = 167.70, P < 0.001) and NIHSS score (B = 8.53, P = 0.014). APOE ε4 is an independent risk factor for poor collaterals.