Haptoglobin phenotype predicts cerebral vasospasm and clinical deterioration after aneurysmal subarachnoid hemorrhage

Hiroyuki Ohnishi, Koji Iihara, Yasuyuki Kaku, Keita Yamauchi, Kenji Fukuda, Kunihiro Nishimura, Michikazu Nakai, Tetsu Satow, Norio Nakajima, Masaya Ikegawa

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28 Citations (Scopus)

Abstract

Vasospasm (VS) and delayed cerebral ischemia (DCI) after subarachnoid hemorrhage (SAH) are thought to greatly affect prognosis. Haptoglobin (Hp) is a hemoglobin-binding protein expressed by a genetic polymorphism (1-1, 2-1, and 2-2). Our objects were to investigate whether the Hp phenotype could predict the incidence of cerebral infarction, favorable outcome, clinical deterioration by DCI, and angiographical VS after aneurysmal SAH. Ninety-five consecutive patients who underwent clipping or coil embolization were studied. Favorable functional outcome was defined as a modified Rankin Scale score of 0-2 at 3 months. Angiographical VS was diagnosed based on cerebral angiography findings performed between days 7 and 10 after SAH. The Hp 2-2 group had a significantly greater risk of angiographical VS than that of Hp 2-1 and 1-1 groups combined on univariate (odds ratio [OR]: 3.60, confidence interval [CI]: 1.49-8.67, P =.003) and multivariate logistic regression analyses after being adjusted for age, sex, Fisher groups, and other risk factors (OR: 3.75, CI: 1.54-9.16, P =.004). The Hp 2-2 group also showed the tendency of a greater risk of clinical deterioration by DCI with marginal significance on univariate and age- and sex-adjusted analyses (univariate OR: 2.46, CI:.90-6.74, P =.080; age- and sex-adjusted OR: 2.46, CI:.89-6.82, P =.080) but not after being adjusted for other multiple risk factors. The Hp 2-2 group was not associated with the favorable 3-month outcome and cerebral infarction (univariate: P =.867, P =.209; multivariate: P =.905, P =.292). The Hp phenotype seems to be associated with a higher rate of angiographical VS and clinical deterioration by DCI but does not affect the incidence of cerebral infarction and favorable outcome.

Original languageEnglish
Pages (from-to)520-526
Number of pages7
JournalJournal of Stroke and Cerebrovascular Diseases
Volume22
Issue number4
DOIs
Publication statusPublished - Jan 1 2013
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Surgery
  • Rehabilitation
  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine

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    Ohnishi, H., Iihara, K., Kaku, Y., Yamauchi, K., Fukuda, K., Nishimura, K., Nakai, M., Satow, T., Nakajima, N., & Ikegawa, M. (2013). Haptoglobin phenotype predicts cerebral vasospasm and clinical deterioration after aneurysmal subarachnoid hemorrhage. Journal of Stroke and Cerebrovascular Diseases, 22(4), 520-526. https://doi.org/10.1016/j.jstrokecerebrovasdis.2013.02.005