Abstract:
BACKGROUND AND PURPOSE:Identification of single-nucleotide polymorphisms (SNPs) associated with increased risk of new intracranial hemorrhage (ICH) after brain arteriovenous malformation (BAVM) diagnosis would facilitate risk stratification and identify potential targets for therapeutic intervention. METHODS:Patients with BAVM were longitudinally followed. Primary outcome was new ICH after diagnosis; censoring events were last follow-up or any BAVM treatment. We genotyped 4 promoter SNPs in 2 inflammatory cytokine genes: interleukin-6 (IL-6-174G>C; IL-6-572G>C) and tumor necrosis factor-alpha (TNF-alpha-238G>A; TNF-alpha-308G>A). Association of genotype with risk of new ICH was screened using chi2; SNPs associated with new ICH were further characterized using Cox proportional hazards. RESULTS:We genotyped 280 patients (50% female; 59% white, mean+/-SD age at diagnosis 37+/-17 years; 40% presenting with ICH). TNF-alpha-238G>A was associated with increased risk of new ICH after diagnosis (chi2; P=0.003). After adjusting for age, race/ethnicity, and clinical presentation, the risk of new ICH was increased for patients with TNF-alpha-238 AG genotype (hazard ratio, 4.01; P=0.015). No other SNP was found to be associated with new ICH. CONCLUSIONS:A TNF-alpha SNP was associated with increased risk of new ICH in the natural course of BAVMs. The role of inflammatory cytokines in the pathogenesis of BAVM hemorrhage merits further study.
journal_name
Strokejournal_title
Strokeauthors
Achrol AS,Pawlikowska L,McCulloch CE,Poon KY,Ha C,Zaroff JG,Johnston SC,Lee C,Lawton MT,Sidney S,Marchuk DA,Kwok PY,Young WL,UCSF BAVM Study Project.doi
10.1161/01.STR.0000195133.98378.4bsubject
Has Abstractpub_date
2006-01-01 00:00:00pages
231-4issue
1eissn
0039-2499issn
1524-4628pii
01.STR.0000195133.98378.4bjournal_volume
37pub_type
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