Combining Imaging and Genetics to Predict Recurrence of Anticoagulation-Associated Intracerebral Hemorrhage.

TitleCombining Imaging and Genetics to Predict Recurrence of Anticoagulation-Associated Intracerebral Hemorrhage.
Publication TypeJournal Article
Year of Publication2020
AuthorsBiffi, A, Urday, S, Kubiszewski, P, Gilkerson, L, Sekar, P, Rodriguez-Torres, A, Bettin, M, Charidimou, A, Pasi, M, Kourkoulis, C, Schwab, K, DiPucchio, Z, Behymer, T, Osborne, J, Morgan, M, Moomaw, CJ, James, ML, Greenberg, SM, Viswanathan, A, M Gurol, E, Worrall, BB, Testai, FD, McCauley, JL, Falcone, GJ, Langefeld, CD, Anderson, CD, Kamel, H, Woo, D, Sheth, KN, Rosand, J
JournalStroke
Volume51
Issue7
Pagination2153-2160
Date Published2020 Jul
ISSN1524-4628
Abstract

BACKGROUND AND PURPOSE: For survivors of oral anticoagulation therapy (OAT)-associated intracerebral hemorrhage (OAT-ICH) who are at high risk for thromboembolism, the benefits of OAT resumption must be weighed against increased risk of recurrent hemorrhagic stroke. The ε2/ε4 alleles of the () gene, MRI-defined cortical superficial siderosis, and cerebral microbleeds are the most potent risk factors for recurrent ICH. We sought to determine whether combining MRI markers and genotype could have clinical impact by identifying ICH survivors in whom the risks of OAT resumption are highest.

METHODS: Joint analysis of data from 2 longitudinal cohort studies of OAT-ICH survivors: (1) MGH-ICH study (Massachusetts General Hospital ICH) and (2) longitudinal component of the ERICH study (Ethnic/Racial Variations of Intracerebral Hemorrhage). We evaluated whether MRI markers and genotype predict ICH recurrence. We then developed and validated a combined -MRI classification scheme to predict ICH recurrence, using Classification and Regression Tree analysis.

RESULTS: Cortical superficial siderosis, cerebral microbleed, and ε2/ε4 variants were independently associated with ICH recurrence after OAT-ICH (all

CONCLUSIONS: Combining MRI and genotype stratifies likelihood of ICH recurrence into high, medium, and low risk. If confirmed in prospective studies, this combined -MRI classification scheme may prove useful for selecting individuals for OAT resumption after ICH.

DOI10.1161/STROKEAHA.120.028310
Alternate JournalStroke
PubMed ID32517581
PubMed Central IDPMC7311289
Grant ListR01 NR018335 / NR / NINR NIH HHS / United States
R01 AG026484 / AG / NIA NIH HHS / United States
U24 NS107136 / NS / NINDS NIH HHS / United States
UM1 HG008895 / HG / NHGRI NIH HHS / United States
K23 NS083711 / NS / NINDS NIH HHS / United States
P50 AG005134 / AG / NIA NIH HHS / United States
U24 NS107215 / NS / NINDS NIH HHS / United States
K23 NS100816 / NS / NINDS NIH HHS / United States
R01 NS093870 / NS / NINDS NIH HHS / United States
R01 NS036695 / NS / NINDS NIH HHS / United States
R24 NS092983 / NS / NINDS NIH HHS / United States
KL2 TR003016 / TR / NCATS NIH HHS / United States
R21 NS106480 / NS / NINDS NIH HHS / United States
U24 NS107222 / NS / NINDS NIH HHS / United States
R01 NS103924 / NS / NINDS NIH HHS / United States
U01 NS069763 / NS / NINDS NIH HHS / United States
U01 NS106513 / NS / NINDS NIH HHS / United States
R01 AG047975 / AG / NIA NIH HHS / United States