Effects of Atorvastatin on Carotid Artery Plaques and Blood Lipids in Stroke Patients with Different ApoE Genotypes

Qi Zhao, Yandong Li and Xiyan Ding

Background and Objective: Atorvastatin is a routine drug for treating stroke, reversing plaque formation and reducing cerebrovascular accidents. However, its efficacy varies among different patients. This study aimed to investigate the effects of atorvastatin on carotid artery plaques and blood lipids in stroke patients with different Apolipoprotein E (ApoE) genotypes. Materials and Methods: The clinical data of 61 stroke patients admitted to the hospital from January, 2018 to December, 2019 were retrospectively included in the observation group, while another 50 healthy individuals undergoing physical examinations were selected as the control group. All patients were tested for ApoE genotype and treated with atorvastatin and the correlation between genotype and lipid-regulating effect was analyzed. Results: After treatment, both ApoE2/2+E3/2 and ApoE3/3 genotype groups showed smaller carotid artery plaque area and lower carotid artery stenosis ratio than before treatment (p<0.05). After treatment, the ApoE3/3 genotype group exhibited a higher proportion of plaque stability than the ApoE4/3+E4/4 genotype group (p<0.05). After treatment, the ApoE2/2+E3/2 and ApoE3/3 genotype groups showed lower TC, TG and LDL-C levels and higher HDL-C levels than the ApoE4/3+E4/4 genotype group (p<0.05). The ApoE3/3 genotype group had a lower incidence of cerebrovascular accidents than the ApoE4/3+E4/4 genotype group (p<0.05). Conclusion: Atorvastatin shows better lipid-lowering effects in patients with ApoE2/2+E3/2 and ApoE3/3 genotypes compared with those with ApoE4/3+E4/4 genotypes. It effectively reduced plaque area, enhanced plaque stability and reduced cerebrovascular accidents. The efficacy of lipid regulation and plaque treatment in stroke patients may be associated with ApoE gene polymorphism.

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