Abstract 3680: Hemostatic Genes Variant Predictivity Of Intracerebral Hematoma Growth

Abstract

BACKGROUND AND PURPOSE: Hematoma expansion (HE), the leading cause of neurological deterioration after intracerebral hemorrhage (ICH). In the present study, we explored whether common genetic variants in within the hemostasis pathway were related to hematoma expansion during the acute period after ICH. METHODS: Patients with spontaneous ICH admitted to the instutional Neuro-ICU from 2009 to 2011 were enrolled in the study (Table 1) and clinical data were collected prospectively. Hematoma size was measured volumetrically for CT scans obtained on or before post-bleed day 2. Baseline models for hematoma growth were construted using backwards-stepwise logistic regression. Genotyping of single nucleotide polymorphisms for 15 genes (Table2) involved in hemostasis was performed and the results were individually included in the above baseline models to test for independent association with hematoma expansion. RESULTS: During the study period, eighty-two patients were enrolled in the study and had complete data. Mean age was 65.9±14.9 and 38% were female. Only von willebrand factor (vWF) was associated with absolute and relative hematoma growth in univariate analysis (p<0.001 and p=0.007, respectively); vWF genotype was independently predictive of relative hematoma growth but only approached significance for absolute hematoma growth (p=0.006 and p=0.097, respectively). CONCLUSIONS: Our genomic analysis of various hemostatic factors identified vWF as a potential predictor of HE in patients with ICH. The identification of vWF SNPs may allow us to better identify patients who are at risk for hematoma enlargement and will benefit the most from treatment. The relationship of vWF with regards to hematoma enlargement in a larger population warrants further study.