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Apolipoprotein E Genotype Predicts Hematoma Expansion in Lobar Intracerebral Hemorrhage.
| Publication Type | Journal Article |
| Authors | Brouwers, HB, Biffi A., Ayres AM, Schwab K., Cortellini L., Romero JM, Rost NS, Viswanathan A., Greenberg SM, Rosand J., and Goldstein JN |
| Abstract | BACKGROUND AND PURPOSE: Hematoma volume is the most potent predictor of outcome in spontaneous intracerebral hemorrhage (ICH), and hematoma expansion after hospital presentation occurs in up to 40% of individuals. Among patients with lobar ICH, the apolipoprotein E (APOE) ε2 allele predicts larger hematoma volumes at presentation. We investigated whether the ε2 allele also identifies individuals at increased risk of hematoma expansion. METHODS: We analyzed 510 patients with primary ICH and genetic data available from an ongoing prospective cohort study. Baseline and follow-up CT scans were assessed for ICH location and volume using computer-assisted volumetric methods. RESULTS: Individuals with lobar ICH who possessed APOE ε2 were at increased risk for hematoma expansion (OR, 2.72; 95% CI, 1.19-6.23; P=0.009). The highest odds of expansion were in patients who qualified for the diagnosis of cerebral amyloid angiopathy-related ICH and carried the APOE ε2 allele (OR, 6.02; 95% CI, 1.60-22.58; P=0.008). There was no effect of ε2 on hematoma expansion in deep ICH and APOE ε4 had no effect on hematoma expansion in lobar or deep ICH. CONCLUSIONS: Possession of APOE ε2 predisposes individuals with lobar ICH to hematoma expansion. This effect is even more pronounced in patients with amyloid angiopathy-related ICH, consistent with the ε2 allele's role in vascular amyloid deposition and vessel fragility. |
| Year of Publication | 2012 |
| Journal | Stroke; a journal of cerebral circulation |
| Date Published (YYYY/MM/DD) | 2012/04/24 |
| ISSN Number | 0039-2499 |
| DOI | 10.1161/STROKEAHA.111.643262 |
| PubMed | http://www.ncbi.nlm.nih.gov/pubmed/22535266?dopt=Abstract |
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