Document Detail


Apolipoprotein E genotype predicts hematoma expansion in lobar intracerebral hemorrhage.
MedLine Citation:
PMID:  22535266     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
H Bart Brouwers; Alessandro Biffi; Alison M Ayres; Kristin Schwab; Lynelle Cortellini; Javier M Romero; Natalia S Rost; Anand Viswanathan; Steven M Greenberg; Jonathan Rosand; Joshua N Goldstein
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2012-04-24
Journal Detail:
Title:  Stroke; a journal of cerebral circulation     Volume:  43     ISSN:  1524-4628     ISO Abbreviation:  Stroke     Publication Date:  2012 Jun 
Date Detail:
Created Date:  2012-05-28     Completed Date:  2012-08-16     Revised Date:  2014-09-14    
Medline Journal Info:
Nlm Unique ID:  0235266     Medline TA:  Stroke     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1490-5     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Alleles*
Apolipoproteins E / genetics*
Cerebral Hemorrhage / epidemiology,  genetics*,  pathology*
Female
Genetic Predisposition to Disease*
Genotype
Hematoma / epidemiology,  genetics*,  pathology
Humans
Male
Middle Aged
Prospective Studies
Retrospective Studies
Grant Support
ID/Acronym/Agency:
5K23NS059774/NS/NINDS NIH HHS; K23 NS059774/NS/NINDS NIH HHS; K23 NS059774-01A2/NS/NINDS NIH HHS; K23 NS064052/NS/NINDS NIH HHS; P50NS051343/NS/NINDS NIH HHS; R01 NS059727/NS/NINDS NIH HHS; R01 NS059727-01A1/NS/NINDS NIH HHS; R01 NS073344/NS/NINDS NIH HHS; R01NS059727/NS/NINDS NIH HHS
Chemical
Reg. No./Substance:
0/Apolipoproteins E
Comments/Corrections
Comment In:
Stroke. 2012 Jun;43(6):1458-9   [PMID:  22511011 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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