AI Article Synopsis
- Few genetic modifications have been linked to subarachnoid hemorrhage (SAH), primarily affecting aneurysm size and formation.
- A study involving 103 SAH patients and 473 controls found that the HPA-1b allele offers protection against SAH while being associated with larger aneurysms but lower hemorrhage severity.
- The presence of the HPA-1b allele may reduce SAH risk and severity, especially for smaller aneurysms, with an enhanced protective effect when combined with the HPA-2b allele.
Article Abstract
Background And Purpose: Few genetic modifications have been identified to be associated with subarachnoid hemorrhage (SAH), most of them playing a role in the formation or size of aneurysms.
Methods: We evaluated the role of common and functional polymorphisms affecting the main platelet adhesive glycoproteins (GP) (GPIIIa: HPA-1; GPIa: HPA-5 and C807T; GPIbalpha: HPA-2 and VNTR) in the risk for development of the disease and in the severity of the onset. The study was performed in 103 patients with SAH, 103 matched controls, and 473 subjects from the general population.
Results: The HPA-1b (PlA2) allele significantly protected against SAH (OR, 0.48; 95% CI, 0.24 to 0.96; P=0.037). Interestingly, patients carrying this allele displayed larger aneurysms, but the extension of their hemorrhage and the clinical grade at presentation was significantly lower when compared with patients HPA-1 a/a (11.9+/-2.8 mm versus 8.8+/-2.2 mm, P=0.0001. Fisher grade < or =2: 68.4% versus 20%; P=0.0001; Hunt and Hess score
Conclusions: We present the first evidence suggesting a protective role for the platelet GPIIIa HPA-1b allele in SAH. The suggested platelet hyper-reactivity determined by this allele could reduce the risk to suffer SAH, specially if the aneurysm is small, attenuate the severity of the hemorrhage, and reduce the clinical grade at presentation. This effect might be amplified by the simultaneous combination with the GPIbalpha HPA-2b allele.
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| http://dx.doi.org/10.1161/01.STR.0000141978.33388.eb | DOI Listing |
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