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Haptoglobin genotype and aneurysmal subarachnoid hemorrhage: Individual patient data analysis.

Publication ,  Journal Article
Gaastra, B; Ren, D; Alexander, S; Bennett, ER; Bielawski, DM; Blackburn, SL; Borsody, MK; Doré, S; Galea, J; Garland, P; He, T; Iihara, K ...
Published in: Neurology
April 30, 2019

OBJECTIVE: To perform an individual patient-level data (IPLD) analysis and to determine the relationship between haptoglobin (HP) genotype and outcomes after aneurysmal subarachnoid hemorrhage (aSAH). METHODS: The primary outcome was favorable outcome on the modified Rankin Scale or Glasgow Outcome Scale up to 12 months after ictus. The secondary outcomes were occurrence of delayed ischemic neurologic deficit, radiologic infarction, angiographic vasospasm, and transcranial Doppler evidence of vasospasm. World Federation of Neurological Surgeons (WFNS) scale, Fisher grade, age, and aneurysmal treatment modality were covariates for both primary and secondary outcomes. As preplanned, a 2-stage IPLD analysis was conducted, followed by these sensitivity analyses: (1) unadjusted; (2) exclusion of unpublished studies; (3) all permutations of HP genotypes; (4) sliding dichotomy; (5) ordinal regression; (6) 1-stage analysis; (7) exclusion of studies not in Hardy-Weinberg equilibrium (HWE); (8) inclusion of studies without the essential covariates; (9) inclusion of additional covariates; and (10) including only covariates significant in univariate analysis. RESULTS: Eleven studies (5 published, 6 unpublished) totaling 939 patients were included. Overall, the study population was in HWE. Follow-up times were 1, 3, and 6 months for 355, 516, and 438 patients. HP genotype was not associated with any primary or secondary outcome. No trends were observed. When taken through the same analysis, higher age and WFNS scale were associated with an unfavorable outcome as expected. CONCLUSION: This comprehensive IPLD analysis, carefully controlling for covariates, refutes previous studies showing that HP1-1 associates with better outcome after aSAH.

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Published In

Neurology

DOI

EISSN

1526-632X

Publication Date

April 30, 2019

Volume

92

Issue

18

Start / End Page

e2150 / e2164

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Subarachnoid Hemorrhage
  • Prognosis
  • Neurology & Neurosurgery
  • Humans
  • Haptoglobins
  • Genotype
  • Alleles
  • 3209 Neurosciences
  • 3202 Clinical sciences
 

Citation

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Gaastra, B., Ren, D., Alexander, S., Bennett, E. R., Bielawski, D. M., Blackburn, S. L., … Galea, I. (2019). Haptoglobin genotype and aneurysmal subarachnoid hemorrhage: Individual patient data analysis. Neurology, 92(18), e2150–e2164. https://doi.org/10.1212/WNL.0000000000007397
Gaastra, Ben, Dianxu Ren, Sheila Alexander, Ellen R. Bennett, Dawn M. Bielawski, Spiros L. Blackburn, Mark K. Borsody, et al. “Haptoglobin genotype and aneurysmal subarachnoid hemorrhage: Individual patient data analysis.Neurology 92, no. 18 (April 30, 2019): e2150–64. https://doi.org/10.1212/WNL.0000000000007397.
Gaastra B, Ren D, Alexander S, Bennett ER, Bielawski DM, Blackburn SL, et al. Haptoglobin genotype and aneurysmal subarachnoid hemorrhage: Individual patient data analysis. Neurology. 2019 Apr 30;92(18):e2150–64.
Gaastra, Ben, et al. “Haptoglobin genotype and aneurysmal subarachnoid hemorrhage: Individual patient data analysis.Neurology, vol. 92, no. 18, Apr. 2019, pp. e2150–64. Pubmed, doi:10.1212/WNL.0000000000007397.
Gaastra B, Ren D, Alexander S, Bennett ER, Bielawski DM, Blackburn SL, Borsody MK, Doré S, Galea J, Garland P, He T, Iihara K, Kawamura Y, Leclerc JL, Meschia JF, Pizzi MA, Tamargo RJ, Yang W, Nyquist PA, Bulters DO, Galea I. Haptoglobin genotype and aneurysmal subarachnoid hemorrhage: Individual patient data analysis. Neurology. 2019 Apr 30;92(18):e2150–e2164.

Published In

Neurology

DOI

EISSN

1526-632X

Publication Date

April 30, 2019

Volume

92

Issue

18

Start / End Page

e2150 / e2164

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Subarachnoid Hemorrhage
  • Prognosis
  • Neurology & Neurosurgery
  • Humans
  • Haptoglobins
  • Genotype
  • Alleles
  • 3209 Neurosciences
  • 3202 Clinical sciences