Document Detail

Apolipoprotein E genotype and outcome after aneurysmal subarachnoid hemorrhage.
MedLine Citation:
PMID:  19199499     Owner:  NLM     Status:  MEDLINE    
OBJECT: After aneurysmal subarachnoid hemorrhage (SAH), conflicting results concerning an association between the APOE genotype and impaired outcome have been reported. The authors tested prospectively whether APOE epsilon2 or epsilon4 allele-containing genotypes (epsilon2+ and epsilon4+) affect outcome after SAH. METHODS: Previous disease histories and clinical and radiological variables were recorded for 105 patients who were admitted within 48 hours after SAH. Fifteen patients (14%) had the epsilon2+ genotype and 31 (30%) [corrected] had epsilon4+ genotypes. Factors predicting poor outcome according to the Glasgow Outcome Scale and cerebral infarction visible on CT scans obtained at 3 months after SAH were tested with multiple logistic regression analyses. RESULTS: Apolipoprotein E epsilon2 or epsilon4-containing genotypes were not associated with outcome, occurrence of cerebral infarction, or with any of their predictors, either in univariate or multivariate analysis. Poor outcome was predicted independently by the occurrence of intraventricular bleeding and intracerebral hematoma as well as by elevated levels of both plasma glucose and D-dimer, and delayed cerebral ischemia (p < 0.05 for each factor), and in univariate analysis only by clinical condition on admission and patient age. Cerebral infarction was predicted independently according to clinical condition on admission (p < 0.05), amount of subarachnoid blood (p < 0.01), duration of intraoperative parent artery clipping (p < 0.01), and body mass index (p < 0.05). In the univariate analysis only cerebral infarction was also predicted by patient age, intracerebral hematoma, and delayed cerebral ischemia. CONCLUSIONS: Severity of bleeding for the most part predicts outcome after SAH; APOE polymorphisms seem to have no prognostic value for outcome after SAH. This result was in accordance with the findings from the largest ischemic stroke studies.
Seppo Juvela; Jari Siironen; Jaakko Lappalainen
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of neurosurgery     Volume:  110     ISSN:  0022-3085     ISO Abbreviation:  J. Neurosurg.     Publication Date:  2009 May 
Date Detail:
Created Date:  2009-05-19     Completed Date:  2009-06-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0253357     Medline TA:  J Neurosurg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  989-95     Citation Subset:  AIM; IM    
Department of Neurosurgery, Helsinki University Central Hospital, Helsinki, Turku, Finland.
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MeSH Terms
Apolipoprotein E2 / genetics*
Apolipoprotein E4 / genetics*
Brain Ischemia / etiology
Cerebral Infarction / etiology
Intracranial Aneurysm / complications*
Middle Aged
Polymorphism, Genetic
Prospective Studies
Subarachnoid Hemorrhage / complications*,  genetics
Reg. No./Substance:
0/Apolipoprotein E2; 0/Apolipoprotein E4
Erratum In:
J Neurosurg. 2009 May;110(5):1042

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

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