Research On The Relationship Between Plasma ApoA1, ApoB, And ApoA1/ApoB Levels And Short-term Prognosis Of Acute Ischemic Stroke

Purpose: To determine whether there is a correlation between acute stage Apolipoprotein A1 (ApoA1) Apolipoprotein B(ApoB) ApoA1/ApoB ratio and the prognosis of acute ischemic stroke(AIS).Method: From 08/24/2005 to 04/25/2007, 251 consecutive patients with AIS confirmed by CT/MRI hospitalized in the Neurology department of the first affiliated hospital of Zhengzhou university were registered prospectively and a detailed stroke registry form was filled. Probable risk factors or predictors for prognosis of ischemic stroke were selected, including age, gender, time duration from onset to treatment, OCSP stroke classification, NIHSS score on admission, acute stage fasting glucose, total cholesterol, ApoA1,ApoB level, and ApoA1/ApoB ratio. 1 month after onset MRS(Modified Rankin Scale) score and BI(Barthel Index) were recorded. Statistics used multivariate Logistic regression analysis. Results: Statistical analysis revealed 102 females (41.1%) ,146 males (58.9%), age: (23y, 93y, Average: 62.46±12.71y) ; time duration from onset to treatment : (0. 1h, 360h) , Percentiles; 50%: 8. 00h; NIHSS score on admission: (1, 56) , Percentiles: 50%: 4; fasting glucose : (3.26mmol/L, 17.58mmol/L) , Percentiles: 50%: 5. 39 mmol/L; ; total cholesterol: (2. 38 mmol/L, 11. 95 mmol/L, Average total cholesterol: 5. 09±1.26mmol/L); ApoA1: (0.20g/L, 2.30g/L), Average ApoA1: 1. 04±0. 29g/L; APOB: (0.40 g/L , 2. 40g/L) , Average APOB: 0. 91±0. 32 g/L; ApoA1/ApoB ratio: (0.21, 5.50) , Percentiles : 50%: 1.17; OCSP stroke classification : TACI 8 (3.2%) , PACI 72 (29%) , LACI 121 (48.8%) , POCI 47 (19.0%) . Follow-up was done at 30±3d and 171patients MRS< 3, 77 patients MRS≥3, 7 died, 172 patients BI>60, 76 patients BI≤60. MRS<3 or BI>60 as independent, MRS≥or BI≤60 as dependent, Logistic regression analysis were performed and showed there was a significant association between ApoA1/ApoB ratio and 1 month MRS of the patient, P=0.042, OR=0.42, 95%CI (0.182,0.969), and so is BI. P=0.046, OR=0.425,95%CI(0.184,0.983). But there is no statistical association between ApoA1 , ApoB and 1month MRS or BI. Other variables significantly correlative to prognosis were: age, time duration from onset to treatment, NIHSS score on admission, and OCSP classification.Conclusions: ApoA1/ApoB ratio in the acute stage of ischemic stroke is significantly correlative to the short period prognosis. Patients with higher ApoA1/ApoB tends to get lower MRS scores at 1 month. Higher ApoA1/ApoB ratio might be a predictor for better outcome of ischemic stroke. Limited by the small sample amount and short follow-up period, the conclusion is not affirmative enough. Further studies are needed to confirm it.