Apolipoprotein E genotype and the risk of recurrent lobar intracerebral hemorrhage.
Apolipoprotein E genotype and the risk of recurrent lobar intracerebral hemorrhage.
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DOI：
10.1056/nejm200001273420403
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发表时间：
2000-01-27
影响因子：
158.5
通讯作者：
Greenberg, SM
中科院分区：
文献类型：
--
作者：
O'Donnell, HC;Rosand, J;Greenberg, SM
Background: Recurrent lobar intracerebral hemorrhage is the hallmark of cerebral amyloid angiopathy. The factors that predispose patients to early recurrence of lobar hemorrhage are unknown. One candidate is the apolipoprotein E gene, since both the epsilon 2 and the epsilon 4 alleles of apolipoprotein E appear to be associated with the severity of amyloid angiopathy.Methods: We performed a prospective, longitudinal study of consecutive elderly patients who survived a lobar intracerebral hemorrhage. The patients were followed for recurrent hemorrhagic stroke by interviews at six-month intervals and reviews of medical records and computed tomographic scans.Results: Nineteen of 71 enrolled patients had recurrent hemorrhages during a mean (+/-SD) follow-up period of 23.9+/-14.8 months, yielding a 2-year cumulative rate of recurrence of 21 percent. The apolipoprotein E genotype was significantly associated with the risk of recurrence. Carriers of the epsilon 2 or epsilon 4 allele had a two-year rate of recurrence of 28 percent, as compared with only 10 percent for patients with the common apolipoprotein E epsilon 3/epsilon 3 genotype (risk ratio, 3.8; 95 percent confidence interval, 1.2 to 11.6; P=0.01). Early recurrence occurred in eight patients, four of whom had the uncommon epsilon 2/epsilon 4 genotype. Also at increased risk for recurrence were patients with a history of hemorrhagic stroke before entry into the study (two-year recurrence, 61 percent; risk ratio, 6.4; 95 percent confidence interval, 2.2 to 18.5; P
