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Jean Louis Vincent - One of the best experts on this subject based on the ideXlab platform.

Stéphane Ranque - One of the best experts on this subject based on the ideXlab platform.

Serge Brimioulle - One of the best experts on this subject based on the ideXlab platform.

Paul A Nyquist - One of the best experts on this subject based on the ideXlab platform.

  • haptoglobin 2 2 genotype is associated with Cerebral Salt Wasting syndrome in aneurysmal subarachnoid hemorrhage
    Neurosurgery, 2016
    Co-Authors: Santosh B Murthy, Justin M Caplan, Wendy C Ziai, Andrew P Levy, Rafael J Tamargo, Gustavo Pradilla, Yogesh Moradiya, Eric B Schneider, Hadar Shalom, Paul A Nyquist
    Abstract:

    BACKGROUND Haptoglobin (Hp) genotype has been shown to be a predictor of clinical outcomes in subarachnoid hemorrhage. Cerebral Salt Wasting (CSW) has been suggested to precede the development of symptomatic vasospasm. OBJECTIVE To determine if Hp genotype was associated with CSW and subsequent vasospasm after aneurysmal subarachnoid hemorrhage. METHODS Hp genotypic determination was done for patients admitted with a diagnosis of subarachnoid hemorrhage. Outcome measures included CSW, delayed Cerebral infarction, and Glasgow Outcome Score of 4 to 5 at 30 days. Criteria for CSW included hyponatremia 4 L in 12 hours with urine sodium >40 mEq/L. RESULTS A total of 133 patients were included in the study. The 3 Hp subgroups did not differ in terms of baseline characteristics. CSW occurred in 1 patient (3.4%) with Hp 1-1, 8 (14.0%) patients with Hp 2-1, and 15 (31.9%) patients with Hp 2-2 (P = .004). In the multivariate regression model, Hp 2-2 was associated with CSW (odds ratio [OR]: 4.94; CI: 1.78-17.43; P = .01), but Hp 2-1 was not (OR: 2.92; CI: 0.56-4.95; P = .15) compared with Hp 1-1. There were no associations between Hp genotypes and functional outcome or delayed Cerebral infarction. CSW was associated with delayed Cerebral infarction (OR: 7.46; 95% CI: 2.54-21.9; P < .001). CONCLUSION Hp 2-2 genotype was an independent predictor of CSW after subarachnoid hemorrhage. Because CSW is strongly associated with delayed Cerebral infarction, the use of Hp genotype testing requires more investigation, and larger prospective confirmation is warranted. Additionally, a more objective definition of CSW needs to be delineated.

  • abstract 42 haptoglobin 2 2 phenotype is associated with Cerebral Salt Wasting syndrome in aneurysmal subarachnoid hemorrhage
    Stroke, 2015
    Co-Authors: Santosh B Murthy, Justin M Caplan, Shalom Hadar, Wendy C Ziai, Andrew P Levy, Rafael J Tamargo, Paul A Nyquist
    Abstract:

    INTRODUCTION: The Haptoglobin (Hp) phenotype has been shown to be a predictor of clinical outcomes in cerebrovascular disorders. We sought to determine if the Hp phenotype was predictive of Cerebral Salt Wasting (CSW) following aneurysmal subarachnoid hemorrhage (SAH). METHODS: Patients admitted with a diagnosis of SAH were divided into three groups based on their genetically determined Hp phenotype: 1-1, 2-1, and 2-2. Outcome measures included CSW, delayed Cerebral infarction (DCI) and favorable outcome -Glasgow Outcome score (GOS) of 4-5 at 30 days. CSW was diagnosed by a clinician, and met the following criteria: hyponatremia 4 liters in 12 hours with urine sodium > 40 mEq/L. Pearson’s Chi Square and Wilcoxon-Mann-Whitney tests were used for categorical and continuous variables respectively. Logistic regression was used to assess association between Hp phenotype and SAH outcomes. RESULTS: A total of 133 patients were included in the study. The distribution of Hp phenotype was- Hp 1-1: 29 (21.8%), Hp 2-1: 57 (42.9%), Hp 2-2: 47 (35.3%). The three Hp subgroups did not differ in terms of demographic variables, comorbidities or SAH characteristics. CSW occurred in 1 patient (3.4%) with Hp 1-1, 8 (14.0%) with Hp 2-1 and 15 (31.9%) with Hp 2-2 (p=0.004). In the multivariate analysis adjusted for age, sex, race, Hunt-Hess score and hydrocephalus, Hp 2-2 was associated with CSW (OR: 4.94 CI: 1.78-17.43, p=0.013) but Hp 2-1 was not (OR: 2.92, CI: 0.56-4.95, p=0.150). There were no associations between Hp phenotypes and favorable outcomes or DCI. CSW correlated strongly with development of DCI (OR: 7.16, OR: 2.48-20.62, p<0.001). CONCLUSIONS: Hp 2-2 phenotype was an independent predictor of Cerebral Salt Wasting following SAH. There were no associations between Hp phenotype and DCI or good functional outcome.

Séverine Genot - One of the best experts on this subject based on the ideXlab platform.