AneurysmApolipoprotein e ϵ4 and the risk of unfavorable outcome after aneurysmal subarachnoid hemorrhage
Section snippets
Patients
Between July 1, 2000 and June 31, 2001, a total of 120 patients with aneurysms were admitted to the Department of Neurosurgery at Beijing Tiantan Hospital. Digital Subtraction Angiography (DSA) or surgery was used to confirm all aneurysms. Patients with subarachnoid hemorrhage (SAH) without confirmation by DSA or surgical detection were excluded from this study. All patients with aneurysmal SAH underwent computed tomography (CT) scanning on admission and were classified using Fisher's grade [6]
Results
A final total of 104 patients were included in this study; 16 patients without confirmed SAH had been excluded. Of these 104 patients available for clinical assessment of aneurysmal SAH and APOE genotype, 12 had unfavorable outcomes at 3 months following SAH, 4 patients had died, and another 8 had a dependent lifestyle.
Except for the genotype with ϵ2/ϵ2, 5 other genotypes were identified in this study. The distributions of APOE genotypes of patients closely resembled those of control subjects (
Discussion
This study also demonstrated that the APOE-ϵ4 allele predisposed to an unfavorable outcome after aneurysmal SAH. The association of APOE-ϵ4 with unfavorable outcome was still observed after multiple regression analysis. Genetic susceptibility for unfavorable outcome after SAH associated with APOE-ϵ4 was implied, but an association of APOE with the incidence of SAH was not supported because there were similar distributions of this gene in both patients and control subjects.
Recent studies showed
Conclusions
Despite the limitations discussed above, our study supports the premise that patients with APOE-ϵ4 allele are likely predisposed to unfavorable outcomes. This may involve the adverse effects of apoE4 on neurobiology and its potential links with risk factors such as vasospasm. But it does not support an association of APOE with the incidence of aneurysmal SAH. Genetic susceptibility needs further study in regard to aneurysmal SAH.
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Role of Apolipoprotein E Genotypes in Aneurysmal Subarachnoid Hemorrhage: Susceptibility, Complications, and Prognosis
2018, World NeurosurgeryCitation Excerpt :The NOS score of included studies ranged from 6 to 9 (median 7) (Table 1). Detailed NOS assessments are illustrated in Supplementary Table 1.18,19,21,22,25-38 Funnel plots were created for publication bias assessment on meta-analysis including at least 9 studies according to the Cochrane Handbook.39
Search for Biomarkers of Intracranial Aneurysms: A Systematic Review
2015, World NeurosurgeryCitation Excerpt :With the limited sample size of 11 patients in the study, further evaluation is needed to understand the role of LPA in IAs (31). Three studies performed genetic analyses of APOE, a primary mediator of cholesterol and lipid transport in the brain in IAs, but did not find any association between the APOE gene and IA occurrence (38). However, Tang et al. reported a tendency for unfavorable outcomes after SAH in the presence of the APOE-e4 allele (38).
Neurosurgery center of Beijing Tiantan Hospital, flagship of neurosurgery in China
2011, World Neurosurgery