troke is an acute temporary, or often permanent damage of the brain. In industrialized countries stroke is the third leading cause of death after cardiovascular disorders and malignant tumors. 1 It can affect both sexes at any time of life; however, it is more prevalent in males and people over 50 years of age. Ischemic stroke results in local dysfunction of the brain and comprises 80% of cases. 2 Ischemic stroke can be unequivocally attributed to numerous classic clinical and environmental risk factors, such as diabetes mellitus, hypertension, smoking and excessive alcohol or drug consumption. 3 The role of several factors in the development of the disease is still the subject of investigations, including the possible significance of increased triglyceride levels. In the past decade numerous genetic susceptibility factors have been verified, which alone or in combination with other genes or exogenous factors can have a role in the development of stroke. [4][5][6][7] The apolipoprotein A5 (APOA5) gene is located nearby the APOAI-APOCIII-APOAIV cluster in the 11q23 chroCirculation Journal Vol.72, July 2008 mosome. It includes 3 exons and encodes 366 amino acids. The mature APOA5 protein is synthesized by the liver and secreted into the plasma where it plays a crucial regulatory role in triglyceride metabolism. 8,9 All of the most frequently occurring variants, T-1131C, T1259C, C56G, IVS3+G476A, have been reported as associated with elevated triglyceride levels, and some of them were also found to be independent risk factors for cardio-and cerebrovascular diseases. [10][11][12] Albeit limited data are available about the role of the T1259C and IVS3+G476A variants in triglyceride metabolism, 11,13 their possible significance in stroke has not been examined at all. We have demonstrated that the T-1131C variant confers susceptibility for ischemic stroke, 14 so as a natural extension, the goal of the present study was to investigate the possible pathogenic role of the 1259C and IVS3+476A allelic variants, and the T-1131C variant was also tested in the study population.
Methods
Study PopulationA total of 378 Caucasian unrelated patients (150 males, 228 females; mean age: 66.1±0.74 years, range: 24-95) with ischemic stroke were enrolled. All of them underwent extended clinical assessment, including general physical and laboratory cardiological and neurological examinations, and past medical and familial histories. After receiving the magnetic resonance imaging (MRI) and clinical neurological results the 378 patients were allocated to 1 of 3 stroke subgroups as previously described. 14 The first group had