title: Presence of haptoglobin-2 allele is associated with worse functional outcomes after spontaneous intracerebral hemorrhage.
abstract: OBJECTIVE
  To determine if the haptoglobin (Hp) phenotype, which has been shown to be a predictor of clinical outcomes in cerebrovascular disorders, particularly subarachnoid hemorrhage, was predictive of functional outcomes after spontaneous intracerebral hemorrhage (ICH).
  
  
  METHODS
  Patients admitted with a diagnosis of ICH were prospectively included and divided into 3 groups based on their genetically determined Hp phenotype: 1-1, 2-1, and 2-2. Outcome measures included mortality and 30-day modified Rankin Scale scores. Demographics and outcomes were compared for each phenotype using multivariate linear regression analysis.
  
  
  RESULTS
  The study included 94 patients. The distribution of Hp phenotype was Hp 1-1, 12 (13%); Hp 2-1, 46 (49%); and Hp 2-2, 36 (38%). The 3 Hp subgroups did not differ in terms of demographic variables, comorbidities, or ICH characteristics. There was a nonsignificant trend toward increased mortality in Hp 2-1 and Hp 2-2 compared with Hp 1-1, with mortality of 8% in Hp 1-1, 17% in Hp 2-1, and 25% in Hp 2-2 (P = 0.408). In the regression model adjusted for confounders, Hp 2-1 (odds ratio = 0.05, 95% confidence interval = 0.01-0.47, P < 0.001) and Hp 2-2 phenotypes (odds ratio = 0.14, 95% confidence interval = 0.02-0.86, P = 0.045) had significantly lower odds of modified Rankin Scale scores 0-2 compared with Hp 1-1.
  
  
  CONCLUSIONS
  After ICH, individuals with the Hp-2 allele (2-1 and 2-2) had worse functional outcomes than individuals with the Hp-1 allele (Hp 1-1). There was a nonsignificant association between Hp phenotype and mortality. Larger prospective studies with better surrogates of ICH outcomes are warranted.
authors.affiliation: Division of Neurosciences Critical Care, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. Electronic address: smurth13@jhmi.edu.
authors.forename: Santosh B
authors.initials: SB
authors.lastname: Murthy
authors.affiliation: Department of Medicine, Technion Institute of Technology, Haifa, Israel.
authors.forename: Andrew P
authors.initials: AP
authors.lastname: Levy
authors.affiliation: Division of Neurosciences Critical Care, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
authors.forename: Joshua
authors.initials: J
authors.lastname: Duckworth
authors.affiliation: Center for Surgical Trials and Outcomes Research, Johns Hopkins University, Baltimore, Maryland, USA.
authors.forename: Eric B
authors.initials: EB
authors.lastname: Schneider
authors.affiliation: Department of Medicine, Technion Institute of Technology, Haifa, Israel.
authors.forename: Hadar
authors.initials: H
authors.lastname: Shalom
authors.affiliation: Division of Neurosciences Critical Care, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
authors.forename: Daniel F
authors.initials: DF
authors.lastname: Hanley
authors.affiliation: Department of Neurological Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
authors.forename: Rafael J
authors.initials: RJ
authors.lastname: Tamargo
authors.affiliation: Division of Neurosciences Critical Care, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
authors.forename: Paul A
authors.initials: PA
authors.lastname: Nyquist
mesh_terms: D000328:Adult; D000368:Aged; D000483:Alleles; D015331:Cohort Studies; D005260:Female; D015600:Glasgow Coma Scale; D006242:Haptoglobins / Q000235:genetics*; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000235:genetics; D020300:Intracranial Hemorrhages / Q000235:genetics* / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010641:Phenotype; D011446:Prospective Studies; D012307:Risk Factors; D013345:Subarachnoid Hemorrhage / Q000235:genetics / Q000401:mortality / Q000628:therapy; D016896:Treatment Outcome
chemical_list: D006242:Haptoglobins
keywords: Clinical outcomes; Haptoglobin phenotype; Intracerebral hemorrhage