Variation in a Locus Linked to Platelet Aggregation Phenotype Predicts Intraparenchymal Hemorrhagic Volume

Keywords: hemorrhage, pituitary adenoma, intracerebral hemorrhage, outcome, blood

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     Alteration in Platelet function has been shown to promote bleeding and affect outcome after intracerebral hemorrhage(ICH).
     We investigated the influence of genetic variants of platelet aggregation,and their effects on admission intracerebral hemorrhagic volume and clinical outcome.
     Exclusion criteria included age younger than 18 years, ICH following trauma, haemorrhagic transformation, or tumor, no consent for genetic analysis, or incomplete data.
     Our prospective study analysed selected candidate SNPs previously associated with platelet aggregation phenotype in previous genome wide association studies, with regards to outcome and ICH volume. Patients were assessed at the Columbia University Medical Center Neuro-Intensive Care Unit.Radiological variables (location and volume of acute ICH, presence of intraventricular extension, midline shift and hydrocephalus) and clinical variables (mortality and mRS score at discharge) were prospectively recorded.
     One hundred and twenty two patients with spontaneous ICH between February 2009 and May 2011 diagnosed via clinical assessment and admission CT scan were included. Median admission Glasgow Coma Scale Score (GCS) was 11.5. Univariate predictors of mortality at discharge included SBP, presence of IVH, anticoagulant use, and GCS, the only independent predictor of discharge mortality (p<0.001). Age, IVH, and GCS were associated with poor functional outcome; age (p=0.001) and GCS (p<0.001) were significant in the multivariate model. Admission GCS (p<0.01), antiplatelet use, and rs342286 (PIK3CG;p=0.04; R2=0.247) had univariate associations with hematoma volume.
     This is a retrospective study.
     We identified SNP rs342286 as an independent predictor of admission hematoma volume.
     Our findings suggest that PIK3CG function, previously linked to this SNP and which affects platelet function, impacts the severity of the intraparenchymal bleed.


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