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Yamada Y, Kato K, Oguri M, Horibe H, Fujimaki T, Yasukochi Y, Takeuchi I, Sakuma J. Identification of nine genes as novel susceptibility loci for early-onset ischemic stroke, intracerebral hemorrhage, or subarachnoid hemorrhage. Biomed Rep 2018; 9:8-20. [PMID: 29930801 PMCID: PMC6006761 DOI: 10.3892/br.2018.1104] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 05/23/2018] [Indexed: 02/07/2023] Open
Abstract
Given that substantial genetic components have been shown in ischemic stroke, intracerebral hemorrhage (ICH), and subarachnoid hemorrhage (SAH), heritability may be higher in early-onset than late-onset individuals with these conditions. Although genome-wide association studies (GWASs) have identified various genes and loci significantly associated with ischemic stroke, ICH, or intracranial aneurysm mainly in European ancestry populations, genetic variants that contribute to susceptibility to these disorders remain to be identified definitively. We performed exome-wide association studies (EWASs) to identify genetic variants that confer susceptibility to ischemic stroke, ICH, or SAH in early-onset subjects with these conditions. A total of 6,649 individuals aged ≤65 years were examined. For the EWAS of ischemic or hemorrhagic stroke, 6,224 individuals (450 subjects with ischemic stroke, 5,774 controls) or 6,179 individuals (261 subjects with ICH, 176 subjects with SAH, 5,742 controls), respectively, were examined. EWASs were performed with the use of Illumina Human Exome-12 v1.2 DNA Analysis BeadChip or Infinium Exome-24 v1.0 BeadChip. To compensate for multiple comparisons of allele frequencies with ischemic stroke, ICH, or SAH, we applied a false discovery rate (FDR) of <0.05 for statistical significance of association. The association of allele frequencies of 31,245 single nucleotide polymorphisms (SNPs) that passed quality control to ischemic stroke was examined with Fisher's exact test, and 31 SNPs were significantly (FDR <0.05) associated with ischemic stroke. The association of allele frequencies of 31,253 or 30,970 SNPs to ICH or SAH, respectively, was examined with Fisher's exact test, and six or two SNPs were significantly associated with ICH or SAH, respectively. Multivariable logistic regression analysis with adjustment for age, sex, and the prevalence of hypertension and diabetes mellitus revealed that 12 SNPs were significantly [P<0.0004 (0.05/124)] related to ischemic stroke. Similar analysis with adjustment for age, sex, and the prevalence of hypertension revealed that six or two SNPs were significantly [P<0.0016 (0.05/32)] related to ICH or SAH, respectively. After examination of linkage disequilibrium of identified SNPs and results of previous GWASs, we identified HHIPL2, CTNNA3, LOC643770, UTP20, and TRIB3 as susceptibility loci for ischemic stroke, DNTTIP2 and FAM205A as susceptibility loci for ICH, and FAM160A1 and OR52E4 as such loci for SAH. Therefore, to the best of our knowledge, we have newly identified nine genes that confer susceptibility to early-onset ischemic stroke, ICH, or SAH. Determination of genotypes for the SNPs in these genes may prove informative for assessment of the genetic risk for ischemic stroke, ICH, or SAH in Japanese.
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Affiliation(s)
- Yoshiji Yamada
- Department of Human Functional Genomics, Advanced Science Research Promotion Center, Mie University, Tsu, Mie 514-8507, Japan.,CREST, Japan Science and Technology Agency, Kawaguchi, Saitama 332-0012, Japan
| | - Kimihiko Kato
- Department of Human Functional Genomics, Advanced Science Research Promotion Center, Mie University, Tsu, Mie 514-8507, Japan.,Department of Internal Medicine, Meitoh Hospital, Nagoya, Aichi 465-0025, Japan
| | - Mitsutoshi Oguri
- Department of Human Functional Genomics, Advanced Science Research Promotion Center, Mie University, Tsu, Mie 514-8507, Japan.,Department of Cardiology, Kasugai Municipal Hospital, Kasugai, Aichi 486-8510, Japan
| | - Hideki Horibe
- Department of Cardiovascular Medicine, Gifu Prefectural Tajimi Hospital, Tajimi, Gifu 507-8522, Japan
| | - Tetsuo Fujimaki
- Department of Cardiovascular Medicine, Northern Mie Medical Center Inabe General Hospital, Inabe, Mie 511-0428, Japan
| | - Yoshiki Yasukochi
- Department of Human Functional Genomics, Advanced Science Research Promotion Center, Mie University, Tsu, Mie 514-8507, Japan.,CREST, Japan Science and Technology Agency, Kawaguchi, Saitama 332-0012, Japan
| | - Ichiro Takeuchi
- CREST, Japan Science and Technology Agency, Kawaguchi, Saitama 332-0012, Japan.,Department of Computer Science, Nagoya Institute of Technology, Nagoya, Aichi 466-8555, Japan.,RIKEN Center for Advanced Intelligence Project, Tokyo 103-0027, Japan
| | - Jun Sakuma
- CREST, Japan Science and Technology Agency, Kawaguchi, Saitama 332-0012, Japan.,RIKEN Center for Advanced Intelligence Project, Tokyo 103-0027, Japan.,Computer Science Department, College of Information Science, University of Tsukuba, Tsukuba, Ibaraki 305-8573, Japan
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Hu X, Tao C, Xie Z, Li Y, Zheng J, Fang Y, Lin S, Li H, You C. The MTHFR C677T Polymorphism and Risk of Intracerebral Hemorrhage in a Chinese Han Population. Med Sci Monit 2016; 22:127-33. [PMID: 26757363 PMCID: PMC4716714 DOI: 10.12659/msm.896315] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism has been speculated to be and extensively investigated as a risk factor for various vascular diseases, including intracerebral hemorrhage (ICH). However, results from published studies regarding the role of C677T polymorphism in ICH risk in Chinese populations were contradictory rather than conclusive. MATERIAL/METHODS In this study, a total of 180 ICH patients and 180 matched controls of Chinese Han ethnicity were enrolled. The MTHFR C677T polymorphism was genotyped by polymerase chain reaction-ligation detection reaction (PCR-LDR). A meta-analysis was conducted by combining our data with previous relevant studies in Chinese populations. RESULTS In our case-control study, similar allele frequency (p=0.492) and genotype distribution (p=0.748) of MTHFR C677T polymorphism were detected between ICH patients and controls. Further analysis based on hematoma location did not show a significant association. When combined with previous studies, however, C677T polymorphism was found to be significantly associated with an increased risk for ICH in Chinese populations (recessive model: OR=1.57, 95%CI=1.29-1.91). When focusing on the Han ethnicity, carriers of the TT genotype had an increased risk of ICH (recessive model: OR=1.36, 95%CI=1.05-1.75). CONCLUSIONS In this case-control study we did not observe that the MTHFR C677T polymorphism was associated with ICH risk in people of Chinese Han ethnicity. However, when combined with previous published studies, a significant association of C677T polymorphism with an increased risk of ICH was detected in Chinese populations, and also in the subgroup analysis focusing on Han ethnicity.
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Affiliation(s)
- Xin Hu
- Stroke Clinical Research Unit, Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, Sichuan, China (mainland)
| | - Chuanyuan Tao
- Stroke Clinical Research Unit, Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, Sichuan, China (mainland)
| | - Zhiyi Xie
- Stroke Clinical Research Unit, Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, Sichuan, China (mainland)
| | - Yunke Li
- Stroke Clinical Research Unit, Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, Sichuan, China (mainland)
| | - Jun Zheng
- Stroke Clinical Research Unit, Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, Sichuan, China (mainland)
| | - Yuan Fang
- Stroke Clinical Research Unit, Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, Sichuan, China (mainland)
| | - Sen Lin
- Stroke Clinical Research Unit, Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, Sichuan, China (mainland)
| | - Hao Li
- Stroke Clinical Research Unit, Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, Sichuan, China (mainland)
| | - Chao You
- Stroke Clinical Research Unit, Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, Sichuan, China (mainland)
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Kase CS, Shoamanesh A, Greenberg SM, Caplan LR. Intracerebral Hemorrhage. Stroke 2016. [DOI: 10.1016/b978-0-323-29544-4.00028-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/08/2022]
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Carpenter AM, Singh IP, Gandhi CD, Prestigiacomo CJ. Genetic risk factors for spontaneous intracerebral haemorrhage. Nat Rev Neurol 2015; 12:40-9. [PMID: 26670299 DOI: 10.1038/nrneurol.2015.226] [Citation(s) in RCA: 66] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Intracerebral haemorrhage (ICH) is associated with the greatest morbidity and mortality of all stroke subtypes. Established risk factors for ICH include hypertension, alcohol use, current cigarette smoking, and use of oral anticoagulants and/or antiplatelet agents. Familial aggregation of ICH has been observed, and the heritability of ICH risk has been estimated at 44%. Few genes have been found to be associated with ICH at the population level, and much of the evidence for genetic risk factors for ICH comes from single studies conducted in relatively small and homogenous populations. In this Review, we summarize the current knowledge of genetic variants associated with primary spontaneous ICH. Two variants of the gene encoding apolipoprotein E (APOE) - which also contributes to the pathogenesis of cerebral amyloid angiopathy - are the most likely candidates for variants that increase the risk of ICH. Other promising candidates for risk alleles in ICH include variants of the genes ACE, PMF1/SLC25A44, COL4A2, and MTHFR. Other genetic variants, related to haemostasis, lipid metabolism, inflammation, and the CNS microenvironment, have been linked to ICH in single candidate gene studies. Although evidence for genetic contributions to the risk of ICH exists, we do not yet fully understand how and to what extent this information can be utilized to prevent and treat ICH.
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Affiliation(s)
- Amanda M Carpenter
- St. George's University, 3500 Sunrise Highway, Great River, NY 11739, USA
| | - Inder P Singh
- Department of Neurological Surgery, Neurological Institute of New Jersey, Rutgers New Jersey Medical School, 90 Bergen Street Suite 8100, Newark, New Jersey 07103, USA
| | - Chirag D Gandhi
- Department of Neurological Surgery, Neurological Institute of New Jersey, Rutgers New Jersey Medical School, 90 Bergen Street Suite 8100, Newark, New Jersey 07103, USA
| | - Charles J Prestigiacomo
- Department of Neurological Surgery, Neurological Institute of New Jersey, Rutgers New Jersey Medical School, 90 Bergen Street Suite 8100, Newark, New Jersey 07103, USA
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Association of ACE gene I/D polymorphism and ACE levels with hemorrhagic stroke: comparison with ischemic stroke. Neurol Sci 2014; 36:137-42. [DOI: 10.1007/s10072-014-1880-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2014] [Accepted: 07/04/2014] [Indexed: 01/05/2023]
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Devan WJ, Falcone GJ, Anderson CD, Jagiella JM, Schmidt H, Hansen BM, Jimenez-Conde J, Giralt-Steinhauer E, Cuadrado-Godia E, Soriano C, Ayres AM, Schwab K, Kassis SB, Valant V, Pera J, Urbanik A, Viswanathan A, Rost NS, Goldstein JN, Freudenberger P, Stögerer EM, Norrving B, Tirschwell DL, Selim M, Brown DL, Silliman SL, Worrall BB, Meschia JF, Kidwell CS, Montaner J, Fernandez-Cadenas I, Delgado P, Greenberg SM, Roquer J, Lindgren A, Slowik A, Schmidt R, Woo D, Rosand J, Biffi A. Heritability estimates identify a substantial genetic contribution to risk and outcome of intracerebral hemorrhage. Stroke 2013; 44:1578-83. [PMID: 23559261 DOI: 10.1161/strokeaha.111.000089] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE Previous studies suggest that genetic variation plays a substantial role in occurrence and evolution of intracerebral hemorrhage (ICH). Genetic contribution to disease can be determined by calculating heritability using family-based data, but such an approach is impractical for ICH because of lack of large pedigree-based studies. However, a novel analytic tool based on genome-wide data allows heritability estimation from unrelated subjects. We sought to apply this method to provide heritability estimates for ICH risk, severity, and outcome. METHODS We analyzed genome-wide genotype data for 791 ICH cases and 876 controls, and determined heritability as the proportion of variation in phenotype attributable to captured genetic variants. Contribution to heritability was separately estimated for the APOE (encoding apolipoprotein E) gene, an established genetic risk factor, and for the rest of the genome. Analyzed phenotypes included ICH risk, admission hematoma volume, and 90-day mortality. RESULTS ICH risk heritability was estimated at 29% (SE, 11%) for non-APOE loci and at 15% (SE, 10%) for APOE. Heritability for 90-day ICH mortality was 41% for non-APOE loci and 10% (SE, 9%) for APOE. Genetic influence on hematoma volume was also substantial: admission volume heritability was estimated at 60% (SE, 70%) for non-APOEloci and at 12% (SE, 4%) for APOE. CONCLUSIONS Genetic variation plays a substantial role in ICH risk, outcome, and hematoma volume. Previously reported risk variants account for only a portion of inherited genetic influence on ICH pathophysiology, pointing to additional loci yet to be identified.
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Affiliation(s)
- William J Devan
- Center for Human Genetic Research, Massachusetts General Hospital, 185 Cambridge St, CPZN-6818, Boston, MA 02114, USA
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Zhao X, Jiang H. Quantitative assessment of the association between MTHFR C677T polymorphism and hemorrhagic stroke risk. Mol Biol Rep 2012. [PMID: 23184002 DOI: 10.1007/s11033-012-2094-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Many studies have investigated the association between methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism and hemorrhagic stroke, but the impact of MTHFR C677T on hemorrhagic stroke is unclear owing to the obvious inconsistence among those studies. This study aimed to quantify the strength of the association between MTHFR C677T polymorphism and hemorrhagic stroke risk. We searched Pubmed, Emabse and Wangfang databases for studies investigating the association between MTHFR C677T polymorphism and hemorrhagic stroke risk. We estimated the pooled odds ratio (OR) with its 95 % confidence intervals (95 % CI) to assess this possible association. Meta-analysis of included studies suggested that TT genotype was obviously associated with increased risk of hemorrhagic stroke (OR (TT versus CC) = 1.84, 95 % CI 1.45-2.34; OR (TT versus CT) = 1.53, 95 % CI 1.23-1.90; OR (TT versus CT/CC) = 1.64, 95 % CI 1.24-2.00) compared with CC or CT genotypes of MTHFR C677T polymorphism. Subgroup analyses by ethnicity further identified the association above in both Asians and Caucasians. No evidence of publication bias was observed. Thus, meta-analyses of available data suggest an obvious association between MTHFR C677T polymorphism and hemorrhagic stroke risk, and TT genotype contributes to increased risk of hemorrhagic stroke.
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Affiliation(s)
- Xianlin Zhao
- Department of Neurosurgery, The Fourth Affiliated Hospital of China Medical University, No. 4 Chongshan East Road, Huanggu District, Shenyang City 110032, Liaoning province, China.
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Yadav S, Schanz R, Maheshwari A, Khan MS, Slark J, de Silva R, Bentley P, Froguel P, Kooner J, Shrivastav P, Prasad K, Sharma P. Bio-Repository of DNA in stroke (BRAINS): a study protocol. BMC MEDICAL GENETICS 2011; 12:34. [PMID: 21366918 PMCID: PMC3061889 DOI: 10.1186/1471-2350-12-34] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/06/2011] [Accepted: 03/02/2011] [Indexed: 11/25/2022]
Abstract
Background Stroke is one of the commonest causes of mortality in the world and anticipated to be an increasing burden to the developing world. Stroke has a genetic basis and identifying those genes may not only help us define the mechanisms that cause stroke but also identify novel therapeutic targets. However, large scale highly phenotyped DNA repositories are required in order for this to be achieved. Methods The proposed Bio-Repository of DNA in Stroke (BRAINS) will recruit all subtypes of stroke as well as controls from two different continents, Europe and Asia. Subjects recruited from the UK will include stroke patients of European ancestry as well as British South Asians. Stroke subjects from South Asia will be recruited from India and Sri Lanka. South Asian cases will also have control subjects recruited. Discussion We describe a study protocol to establish a large and highly characterized stroke biobank in those of European and South Asian descent. With different ethnic populations being recruited, BRAINS has the ability to compare and contrast genetic risk factors between those of differing ancestral descent as well as those who migrate into different environments.
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Affiliation(s)
- Sunaina Yadav
- Imperial College Cerebrovascular Research Unit (ICCRU), Imperial College London, UK
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Kase CS, Greenberg SM, Mohr J, Caplan LR. Intracerebral Hemorrhage. Stroke 2011. [DOI: 10.1016/b978-1-4160-5478-8.10029-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Chen YC, Hu FJ, Chen P, Wu YR, Wu HC, Chen ST, Lee-Chen GJ, Chen CM. Association of TNF-alpha gene with spontaneous deep intracerebral hemorrhage in the Taiwan population: a case control study. BMC Neurol 2010; 10:41. [PMID: 20534169 PMCID: PMC2891694 DOI: 10.1186/1471-2377-10-41] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2009] [Accepted: 06/10/2010] [Indexed: 11/26/2022] Open
Abstract
Background Genetic factors may play a role in susceptibility to spontaneous deep intracerebral hemorrhage (SDICH). Previous studies have shown that TNF-α gene variation was associated with risks of subarachnoid hemorrhage in multiple ethnicities. The present case-control study tested the hypothesis that genetic variations of the TNF-α gene may affect the risk of Taiwanese SDICH. We examined the association of SDICH risks with four single nucleotide polymorphisms (SNPs) within the TNF-α gene promoter, namely T-1031C, C-863A, C-857T, and G-308A. Methods Genotyping was determined by PCR-based restriction and electrophoresis assay for 260 SDICH patients and 368 controls. Associations were tested by logistic regression or general linear models with adjusting for multiple covariables in each gender group, and then in combined. Multiplicative terms of gender and each of the four SNPs were applied to detect the interaction effects on SDICH risks. To account for the multiple testing, permutation testing of 1,000 replicates was performed for empirical estimates. Results In an additive model, SDICH risks were positively associated with the minor alleles -1031C and -308A in men (OR = 1.9, 95% CI 1.1 to 3.4, p = 0.03 and OR = 2.6, 95% CI 1.3 to 5.3, p = 0.005, respectively) but inversely associated with -863A in females (OR = 0.5, 95% CI 0.2 to 0.9, p = 0.03). There were significant interaction effects between gender and SNP on SDICH risks regarding SNPs T-1031C, C-863A, and G-308A (p = 0.005, 0.005, and 0.007, respectively). Hemorrhage size was inversely associated with -857T in males (p = 0.04). Conclusions In the Taiwan population, the associations of genetic variations in the TNF-α gene promoter with SDICH risks are gender-dependent.
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Affiliation(s)
- Yi-Chun Chen
- Department of Neurology, Chang Gung Memorial Hospital Linkou Medical Center and College of Medicine, Chang-Gung University, Taoyuan, Taiwan
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Brenner DA, Alberts MJ, Amarenco P. Clinical genetic issues in stroke. HANDBOOK OF CLINICAL NEUROLOGY 2009; 92:355-372. [PMID: 18790284 DOI: 10.1016/s0072-9752(08)01918-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Affiliation(s)
- David A Brenner
- University of Alabama at Birmingham, Comprehensive Stroke Center, Birmingham, AL 35249, USA.
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Peck G, Smeeth L, Whittaker J, Casas JP, Hingorani A, Sharma P. The genetics of primary haemorrhagic stroke, subarachnoid haemorrhage and ruptured intracranial aneurysms in adults. PLoS One 2008; 3:e3691. [PMID: 19008959 PMCID: PMC2579487 DOI: 10.1371/journal.pone.0003691] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2008] [Accepted: 10/14/2008] [Indexed: 12/11/2022] Open
Abstract
Background The genetic basis of haemorrhagic stroke has proved difficult to unravel, partly hampered by the small numbers of subjects in any single study. A meta-analysis of all candidate gene association studies of haemorrhagic stroke (including ruptured subarachnoid haemorrhage and amyloid angiopathy-related haemorrhage) was performed, allowing more reliable estimates of risk. Methods A systematic review and meta-analysis of all genetic studies in haemorrhagic stroke was conducted. Electronic databases were searched until and including March 2007 for any candidate gene in haemorrhagic stroke. Odds ratio (OR) and 95% confidence intervals (CI) were determined for each gene disease association using fixed and random effect models. Results Our meta-analyses included 6,359 cases and 13,805 controls derived from 55 case-control studies, which included 12 genes (13 polymorphisms). Statistically significant associations with haemorrhagic stroke were identified for those homozygous for the ACE/I allele (OR, 1.48; 95% CI, 1.20–1.83; p = 0.0003) and for the 5G allele in the SERPINE1 4G/5G polymorphism (OR, 1.42; 95% CI, 1.03–1.96; p = 0.03). In addition, both &b.epsi;2 and &b.epsi;4 alleles of APOE were significantly associated with lobar haemorrhage (OR, 1.81; 95% CI, 1.26–2.62; p = 0.002 and OR, 1.49; 95% 1.08–2.05; p = 0.01 respectively). Furthermore, a significant protective association against haemorrhagic stroke was found for the factor V Leiden mutation (OR, 0.30; 95% CI, 0.10–0.87; p = 0.03). Conclusion Our data suggests a genetic contribution to some types of haemorrhagic stroke, with no overall responsible single gene but rather supporting a polygenic aetiology . However, the evidence base is smaller compared to ischaemic stroke. Importantly, for several alleles previously found to be associated with protection from ischaemic stroke, there was a trend towards an increased risk of haemorrhagic stroke.
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Affiliation(s)
- George Peck
- Imperial College Cerebrovascular Research Unit (ICCRU), Department of Clinical Neuroscience, Imperial College London & Hammersmith Hospitals, London, United Kingdom
| | - Liam Smeeth
- Department of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, University of London, London, United Kingdom
| | - John Whittaker
- Department of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, University of London, London, United Kingdom
| | - Juan Pablo Casas
- Department of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, University of London, London, United Kingdom
| | - Aroon Hingorani
- Centre for Clinical Pharmacology, BHF Laboratories, University of London, London, United Kingdom
| | - Pankaj Sharma
- Imperial College Cerebrovascular Research Unit (ICCRU), Department of Clinical Neuroscience, Imperial College London & Hammersmith Hospitals, London, United Kingdom
- * E-mail:
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Yamada Y, Metoki N, Yoshida H, Satoh K, Kato K, Hibino T, Yokoi K, Watanabe S, Ichihara S, Aoyagi Y, Yasunaga A, Park H, Tanaka M, Nozawa Y. Genetic Factors for Ischemic and Hemorrhagic Stroke in Japanese Individuals. Stroke 2008; 39:2211-8. [DOI: 10.1161/strokeaha.107.507459] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Yoshiji Yamada
- From the Department of Human Functional Genomics (Y.Y., S.I.), Life Science Research Center, Mie University, Tsu, Japan; Department of Internal Medicine (N.M.), Hirosaki Stroke Center, Hirosaki, Japan; Department of Vascular Biology (H.Y., K.S.), Institute of Brain Science, Hirosaki University Graduate School of Medicine, Hirosaki, Japan; Department of Cardiovascular Medicine (K.K., T.H., K.Y.), Gifu Prefectural Tajimi Hospital, Tajimi, Japan; Department of Cardiology (S.W.), Gifu Prefectural
| | - Norifumi Metoki
- From the Department of Human Functional Genomics (Y.Y., S.I.), Life Science Research Center, Mie University, Tsu, Japan; Department of Internal Medicine (N.M.), Hirosaki Stroke Center, Hirosaki, Japan; Department of Vascular Biology (H.Y., K.S.), Institute of Brain Science, Hirosaki University Graduate School of Medicine, Hirosaki, Japan; Department of Cardiovascular Medicine (K.K., T.H., K.Y.), Gifu Prefectural Tajimi Hospital, Tajimi, Japan; Department of Cardiology (S.W.), Gifu Prefectural
| | - Hidemi Yoshida
- From the Department of Human Functional Genomics (Y.Y., S.I.), Life Science Research Center, Mie University, Tsu, Japan; Department of Internal Medicine (N.M.), Hirosaki Stroke Center, Hirosaki, Japan; Department of Vascular Biology (H.Y., K.S.), Institute of Brain Science, Hirosaki University Graduate School of Medicine, Hirosaki, Japan; Department of Cardiovascular Medicine (K.K., T.H., K.Y.), Gifu Prefectural Tajimi Hospital, Tajimi, Japan; Department of Cardiology (S.W.), Gifu Prefectural
| | - Kei Satoh
- From the Department of Human Functional Genomics (Y.Y., S.I.), Life Science Research Center, Mie University, Tsu, Japan; Department of Internal Medicine (N.M.), Hirosaki Stroke Center, Hirosaki, Japan; Department of Vascular Biology (H.Y., K.S.), Institute of Brain Science, Hirosaki University Graduate School of Medicine, Hirosaki, Japan; Department of Cardiovascular Medicine (K.K., T.H., K.Y.), Gifu Prefectural Tajimi Hospital, Tajimi, Japan; Department of Cardiology (S.W.), Gifu Prefectural
| | - Kimihiko Kato
- From the Department of Human Functional Genomics (Y.Y., S.I.), Life Science Research Center, Mie University, Tsu, Japan; Department of Internal Medicine (N.M.), Hirosaki Stroke Center, Hirosaki, Japan; Department of Vascular Biology (H.Y., K.S.), Institute of Brain Science, Hirosaki University Graduate School of Medicine, Hirosaki, Japan; Department of Cardiovascular Medicine (K.K., T.H., K.Y.), Gifu Prefectural Tajimi Hospital, Tajimi, Japan; Department of Cardiology (S.W.), Gifu Prefectural
| | - Takeshi Hibino
- From the Department of Human Functional Genomics (Y.Y., S.I.), Life Science Research Center, Mie University, Tsu, Japan; Department of Internal Medicine (N.M.), Hirosaki Stroke Center, Hirosaki, Japan; Department of Vascular Biology (H.Y., K.S.), Institute of Brain Science, Hirosaki University Graduate School of Medicine, Hirosaki, Japan; Department of Cardiovascular Medicine (K.K., T.H., K.Y.), Gifu Prefectural Tajimi Hospital, Tajimi, Japan; Department of Cardiology (S.W.), Gifu Prefectural
| | - Kiyoshi Yokoi
- From the Department of Human Functional Genomics (Y.Y., S.I.), Life Science Research Center, Mie University, Tsu, Japan; Department of Internal Medicine (N.M.), Hirosaki Stroke Center, Hirosaki, Japan; Department of Vascular Biology (H.Y., K.S.), Institute of Brain Science, Hirosaki University Graduate School of Medicine, Hirosaki, Japan; Department of Cardiovascular Medicine (K.K., T.H., K.Y.), Gifu Prefectural Tajimi Hospital, Tajimi, Japan; Department of Cardiology (S.W.), Gifu Prefectural
| | - Sachiro Watanabe
- From the Department of Human Functional Genomics (Y.Y., S.I.), Life Science Research Center, Mie University, Tsu, Japan; Department of Internal Medicine (N.M.), Hirosaki Stroke Center, Hirosaki, Japan; Department of Vascular Biology (H.Y., K.S.), Institute of Brain Science, Hirosaki University Graduate School of Medicine, Hirosaki, Japan; Department of Cardiovascular Medicine (K.K., T.H., K.Y.), Gifu Prefectural Tajimi Hospital, Tajimi, Japan; Department of Cardiology (S.W.), Gifu Prefectural
| | - Sahoko Ichihara
- From the Department of Human Functional Genomics (Y.Y., S.I.), Life Science Research Center, Mie University, Tsu, Japan; Department of Internal Medicine (N.M.), Hirosaki Stroke Center, Hirosaki, Japan; Department of Vascular Biology (H.Y., K.S.), Institute of Brain Science, Hirosaki University Graduate School of Medicine, Hirosaki, Japan; Department of Cardiovascular Medicine (K.K., T.H., K.Y.), Gifu Prefectural Tajimi Hospital, Tajimi, Japan; Department of Cardiology (S.W.), Gifu Prefectural
| | - Yukitoshi Aoyagi
- From the Department of Human Functional Genomics (Y.Y., S.I.), Life Science Research Center, Mie University, Tsu, Japan; Department of Internal Medicine (N.M.), Hirosaki Stroke Center, Hirosaki, Japan; Department of Vascular Biology (H.Y., K.S.), Institute of Brain Science, Hirosaki University Graduate School of Medicine, Hirosaki, Japan; Department of Cardiovascular Medicine (K.K., T.H., K.Y.), Gifu Prefectural Tajimi Hospital, Tajimi, Japan; Department of Cardiology (S.W.), Gifu Prefectural
| | - Akitomo Yasunaga
- From the Department of Human Functional Genomics (Y.Y., S.I.), Life Science Research Center, Mie University, Tsu, Japan; Department of Internal Medicine (N.M.), Hirosaki Stroke Center, Hirosaki, Japan; Department of Vascular Biology (H.Y., K.S.), Institute of Brain Science, Hirosaki University Graduate School of Medicine, Hirosaki, Japan; Department of Cardiovascular Medicine (K.K., T.H., K.Y.), Gifu Prefectural Tajimi Hospital, Tajimi, Japan; Department of Cardiology (S.W.), Gifu Prefectural
| | - Hyuntae Park
- From the Department of Human Functional Genomics (Y.Y., S.I.), Life Science Research Center, Mie University, Tsu, Japan; Department of Internal Medicine (N.M.), Hirosaki Stroke Center, Hirosaki, Japan; Department of Vascular Biology (H.Y., K.S.), Institute of Brain Science, Hirosaki University Graduate School of Medicine, Hirosaki, Japan; Department of Cardiovascular Medicine (K.K., T.H., K.Y.), Gifu Prefectural Tajimi Hospital, Tajimi, Japan; Department of Cardiology (S.W.), Gifu Prefectural
| | - Masashi Tanaka
- From the Department of Human Functional Genomics (Y.Y., S.I.), Life Science Research Center, Mie University, Tsu, Japan; Department of Internal Medicine (N.M.), Hirosaki Stroke Center, Hirosaki, Japan; Department of Vascular Biology (H.Y., K.S.), Institute of Brain Science, Hirosaki University Graduate School of Medicine, Hirosaki, Japan; Department of Cardiovascular Medicine (K.K., T.H., K.Y.), Gifu Prefectural Tajimi Hospital, Tajimi, Japan; Department of Cardiology (S.W.), Gifu Prefectural
| | - Yoshinori Nozawa
- From the Department of Human Functional Genomics (Y.Y., S.I.), Life Science Research Center, Mie University, Tsu, Japan; Department of Internal Medicine (N.M.), Hirosaki Stroke Center, Hirosaki, Japan; Department of Vascular Biology (H.Y., K.S.), Institute of Brain Science, Hirosaki University Graduate School of Medicine, Hirosaki, Japan; Department of Cardiovascular Medicine (K.K., T.H., K.Y.), Gifu Prefectural Tajimi Hospital, Tajimi, Japan; Department of Cardiology (S.W.), Gifu Prefectural
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15
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Abstract
BACKGROUND AND PURPOSE Intracerebral hemorrhage (ICH), the acute manifestation of a common progressive cerebrovascular disease of the elderly, is the most fatal and least treatable form of stroke. There is a desperate need for ICH-specific therapeutics and effective primary prevention strategies, a need that is certain to grow with the aging of the population. Data point to a sizable genetic component to ICH susceptibility. Identification of ICH-related genes therefore holds promise for identifying novel biological targets for ICH prevention. This review focuses on evidence for a genetic contribution to ICH, delineates approaches to genetic studies of ICH, and explores foundations for their future applications. SUMMARY OF REVIEW ICH occurs both sporadically and as part of familial syndromes. Monogenic disorders associated with ICH or microscopic bleeding, such as hereditary cerebral amyloid angiopathy, CADASIL, and collagen type IV A1-associated vasculopathy, demonstrate the potent effect of rare mutations. Dissecting the more complex genetics of sporadic ICH, however, will likely require defining multiple common DNA variants with weaker effects. Advances in high-throughput genotyping technology, computational and analytic methodologies, and large-scale collaborative efforts have already led to the identification of new genetic risk factors for dozens of common diseases. Such whole-genome association studies are being undertaken in sporadic ICH. CONCLUSIONS Investigations of genetic risk factors for sporadic ICH have thus far been limited to candidate gene polymorphisms. Genome-wide association studies currently hold the greatest hope for robust discovery of ICH genes, which can generate novel insights into ICH biology and strategies for prevention.
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Affiliation(s)
- Natalia S Rost
- Department of Neurology, and Hemorrhagic Stroke Research Program, Massachusetts General Hospital, 185 Cambridge Street, Boston MA 02114, USA
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16
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Woo D, Sekar P, Chakraborty R, Haverbusch MA, Flaherty ML, Kissela BM, Kleindorfer D, Schneider A, Khoury J, Sauerbeck LR, Deka R, Broderick JP. Genetic epidemiology of intracerebral hemorrhage. J Stroke Cerebrovasc Dis 2008; 14:239-43. [PMID: 16557295 PMCID: PMC1615714 DOI: 10.1016/j.jstrokecerebrovasdis.2005.08.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
We have previously reported that family history of intracerebral hemorrhage (ICH) was associated with both lobar and nonlobar ICH. We sought to further examine this finding by analyzing differences by age and by apolipoprotein E (Apo E) genotype. All cases of hemorrhagic stroke in the greater Cincinnati area were identified through retrospective screening, and a subset was invited to undergo a direct interview and genetic testing. Interviewed subjects were matched to 2 controls by age, race, and sex. Conditional stepwise logistic regression modeling was used to determine whether having a first-degree relative with an ICH (FHICH) was an independent risk factor for ICH. Between May 1997 and December 2002, we recruited 333 cases of ICH. FHICH was found to be an independent risk factor for both lobar ICH (odds ratio [OR] = 3.9; P = .04) and nonlobar ICH (OR ratio = 5.4; P = .01) after controlling for the presence of numerous variables. Among nonlobar ICH cases, the risk appeared to be predominately in those age < 70 years. The presence of Apo E4 was associated with lobar ICH at age >/= 70 years but not at age < 70 years. Family history of ICH appears to be a significant risk factor for nonlobar ICH at age < 70 years. The presence of Apo E4 appears to be a risk factor for lobar ICH at age >/= 70 years but not at age < 70 years. Family history of ICH is a risk factor for lobar ICH after controlling for the presence of Apo E4.
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Affiliation(s)
- Daniel Woo
- Department of Environmental Health
- Corresponding Author: Daniel Woo, MD, Assistant Professor of Neurology, University of Cincinnati College of Medicine, 231 Albert Sabin Way ML0525, Cincinnati, OH 45267-0525, Phone: 513-558-5478, Fax: 513-558-4887,
| | - Padmini Sekar
- Center for Genome Information, University of Cincinnati College of Medicine; 231 Albert Sabin Way ML 0525; Cincinnati, OH 45267-0525
| | | | | | | | | | | | | | | | - Laura R. Sauerbeck
- Center for Genome Information, University of Cincinnati College of Medicine; 231 Albert Sabin Way ML 0525; Cincinnati, OH 45267-0525
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17
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Abstract
Genetic predisposition to stroke has been proven in animal models and in humans. Unraveling the genetic factors that play a role in common stroke is very difficult, as the causation of stroke is multifactorial (a combination of environmental and genetic risk factors) and the genetic part is very complex (polygenic, multiple genes play a role). Many common risk factors for stroke like diabetes and arterial hypertension are partly inherited, so many genetic loci contribute more or less to the stroke phenotype. Recent knowledge is increased for monogenic forms of stroke, such as cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy and the amyloid angiopathies. These disorders can serve as models to study environmental or genetic factors that contribute also to the common forms of stroke. Animal model of stroke can also provide valuable information on genetic factors involved in stroke predisposition. In this review, the focus lies on monogenic forms of stroke that can serve as models to study the more common phenotypes.
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Affiliation(s)
- Martijn Tonk
- Department of Neurology, Leiden University Medical Centre, The Netherlands
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18
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Lin TJ, Hwang FC, Chen CJ, Chiu WT, Chang CK. Familial hypertensive intracerebral hemorrhage and autosomal dominant polycystic kidney disease. J Clin Neurosci 2005; 12:474-7. [PMID: 15925788 DOI: 10.1016/j.jocn.2004.05.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2003] [Accepted: 05/31/2004] [Indexed: 11/16/2022]
Abstract
Autosomal dominant polycystic kidney disease (ADPKD) is a generalized disease known to be associated with intracranial aneurysms. Non-aneurysmal intracerebral hemorrhage (ICH) has also been reported in ADPKD. We report a familial clustering of ICH and symptomatic ADPKD. This pedigree had at least six affected family members who suffered from ADPKD, hypertension and non-aneurysmal ICH. The proband demonstrated ADPKD, hypertension and cerebral hemorrhage. To our knowledge, this is the first report of familial ICH in ADPKD, which may have underlying genetic and environmental etiologies.
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Affiliation(s)
- Tien-Jen Lin
- Division of Neurosurgery, Department of Surgery, Municipal Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
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19
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Mano MS, Awada A, Minisini A, Atalay G, Lago LD, Cardoso F, Piccart M. Remaining controversies in the upfront management of advanced ovarian cancer. Int J Gynecol Cancer 2004; 14:707-20. [PMID: 15361178 DOI: 10.1111/j.1048-891x.2004.014502.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Ovarian cancer (OC) is one of the leading causes of cancer-related death in women. In the last decades, a lot of energy and resources have been put into a number of clinical trials, with some success. Nevertheless, the prognosis of patients diagnosed with advanced disease remains extremely poor. As research moved forward, some crucial questions with regard to the optimal upfront management of patients with advanced OC (AOC) have remained unanswered. In this article, we review the rationale behind these controversial issues, and provide the levels of evidence supporting the current recommendations for AOC management.
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Affiliation(s)
- M S Mano
- Unité de Chimiothérapie, Institut Jules Bordet, Brussels, Belgium.
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20
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21
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Affiliation(s)
- Mark J Alberts
- Northwestern University Medical School, Chicago, Ill 60611, USA.
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22
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Abstract
Genetic studies of primary intracerebral hemorrhage (PICH) have begun to yield important biologic insights into the pathogenesis of this disorder. This review of candidate genes for PICH emphasizes the value of focusing on individual pathogenic phenotypes. One type of PICH in particular, cerebral amyloid angiopathy, is known to have specific genetic factors regulating both its familial and sporadic forms. Another promising research method is to focus on pathways involved in hemostasis that may be etiologically relevant to all types of PICH. Genetic studies will improve our understanding of the biology of PICH, and may eventually be incorporated into clinical decision making regarding anticoagulation.
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Affiliation(s)
- Steven M Greenberg
- Neurology Clinical Trials Unit, Department of Neurology, Massachusetts General Hospital, Boston, MA 02114, USA.
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23
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Woo D, Sauerbeck LR, Kissela BM, Khoury JC, Szaflarski JP, Gebel J, Shukla R, Pancioli AM, Jauch EC, Menon AG, Deka R, Carrozzella JA, Moomaw CJ, Fontaine RN, Broderick JP. Genetic and environmental risk factors for intracerebral hemorrhage: preliminary results of a population-based study. Stroke 2002; 33:1190-5. [PMID: 11988589 DOI: 10.1161/01.str.0000014774.88027.22] [Citation(s) in RCA: 277] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE Intracerebral hemorrhage (ICH) has a 30-day mortality rate of 40% to 50% and lacks a proven treatment. We report a preplanned, midpoint analysis of the first population-based, case-control study that examines both genetic and environmental risk factors of ICH. METHODS We prospectively identified cases of hemorrhagic stroke at all 16 hospitals in the Greater Cincinnati/Northern Kentucky region. All cases underwent medical record and neuroimaging review. Cases enrolled in the direct interview and genetic sampling arm of the study were matched to population-based control subjects by age, race, and sex. Multivariable logistic regression was performed to identify significant independent risk factors. RESULTS We enrolled 188 cases of ICH (67 lobar, 121 nonlobar) and 366 control subjects in the direct interview arm of the study. Significant independent risk factors for lobar ICH included the presence of an apolipoprotein E2 or E4 allele, frequent alcohol use, prior stroke, and first-degree relative with ICH. Significant independent risk factors for nonlobar ICH were hypertension, prior stroke, and first-degree relative with ICH. An increasing level of education was associated with a decreased risk of nonlobar ICH. The attributable risk of apolipoprotein E2 or E4 for lobar ICH was 29%, and the attributable risk of hypertension for nonlobar ICH was 54%. CONCLUSIONS There is significant epidemiological evidence that the pathophysiology of ICH varies by location. We estimate that a third of all cases of lobar ICH are attributable to possession of an apolipoprotein E4 or E2 allele and that half of all cases of nonlobar ICH are attributable to hypertension.
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Affiliation(s)
- Daniel Woo
- Department of Neurology, University of Cincinnati, Cincinnati, Ohio 45267-0525, USA.
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