| Apolipoprotein E genotype predicts hematoma expansion in lobar intracerebral hemorrhage. | |
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MedLine Citation:
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PMID: 22535266 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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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:
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Type: Clinical Trial; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't Date: 2012-04-24 |
Journal Detail:
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Title: Stroke; a journal of cerebral circulation Volume: 43 ISSN: 1524-4628 ISO Abbreviation: Stroke Publication Date: 2012 Jun |
Date Detail:
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Created Date: 2012-05-28 Completed Date: 2012-08-16 Revised Date: 2013-04-16 |
Medline Journal Info:
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Nlm Unique ID: 0235266 Medline TA: Stroke Country: United States |
Other Details:
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Languages: eng Pagination: 1490-5 Citation Subset: IM |
Affiliation:
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Center for Human Genetic Research-Rosand Lab, Massachusetts General Hospital, Harvard Medical School, 185 Cambridge Street, CPZN-6818, Boston, MA 02114, USA. brouwers@chgr.mgh.harvard.edu |
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| MeSH Terms | |
Descriptor/Qualifier:
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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:
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5K23NS059774/NS/NINDS NIH HHS; K23 NS059774/NS/NINDS NIH HHS; K23 NS059774-01A2/NS/NINDS NIH HHS; P50NS051343/NS/NINDS NIH HHS; R01 NS059727-01A1/NS/NINDS NIH HHS; R01NS059727/NS/NINDS NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Apolipoproteins E |
| Comments/Corrections | |
Comment In:
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Stroke. 2012 Jun;43(6):1458-9
[PMID:
22511011
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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