|Publication Type||Journal Article|
|Year of Publication||2012|
|Authors||H Brouwers, B, Biffi, A, Ayres, AM, Schwab, K, Cortellini, L, Romero, JM, Rost, NS, Viswanathan, A, Greenberg, SM, Rosand, J, Goldstein, JN|
|Date Published||2012 Jun|
|Keywords||Aged, Aged, 80 and over, Alleles, Apolipoproteins E, Cerebral Hemorrhage, Female, Genetic Predisposition to Disease, Genotype, Hematoma, Humans, Male, Middle Aged, Prospective Studies, Retrospective Studies|
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.
|PubMed Central ID||PMC3361564|
|Grant List||K23 NS064052 / NS / NINDS NIH HHS / United States |
K23 NS059774 / NS / NINDS NIH HHS / United States
5K23NS059774 / NS / NINDS NIH HHS / United States
R01 NS059727-01A1 / NS / NINDS NIH HHS / United States
K23 NS059774-01A2 / NS / NINDS NIH HHS / United States
P50NS051343 / NS / NINDS NIH HHS / United States
P50 NS051343 / NS / NINDS NIH HHS / United States
R01 NS059727 / NS / NINDS NIH HHS / United States
R01NS059727 / NS / NINDS NIH HHS / United States
R01 NS073344 / NS / NINDS NIH HHS / United States