| Summary: | Abstract 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.
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