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Falcone GJ, Radmanesh F, Brouwers HB, Battey TWK, Devan WJ, Valant V, Raffeld MR, Chitsike LP, Ayres AM, Schwab K, Goldstein JN, Viswanathan A, Greenberg SM, Selim M, Meschia JF, Brown DL, Worrall BB, Silliman SL, Tirschwell DL, Flaherty ML, Martini SR, Deka R, Biffi A, Kraft P, Woo D, Rosand J, Anderson CD. APOE ε variants increase risk of warfarin-related intracerebral hemorrhage. Neurology 2014; 83:1139-46. [PMID: 25150286 DOI: 10.1212/wnl.0000000000000816] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVE We aimed to assess the effect of APOE ε variants on warfarin-related intracerebral hemorrhage (wICH), evaluated their predictive power, and tested for interaction with warfarin in causing wICH. METHODS This was a prospective, 2-stage (discovery and replication), case-control study. wICH was classified as lobar or nonlobar based on the location of the hematoma. Controls were sampled from ambulatory clinics (discovery) and random digit dialing (replication). APOE ε variants were directly genotyped. A case-control design and logistic regression analysis were utilized to test for association between APOE ε and wICH. A case-only design and logistic regression analysis were utilized to test for interaction between APOE ε and warfarin. Receiver operating characteristic curves were implemented to evaluate predictive power. RESULTS The discovery stage included 319 wICHs (44% lobar) and 355 controls. APOE ε2 was associated with lobar (odds ratio [OR] 2.46; p < 0.001) and nonlobar wICH (OR 1.67; p = 0.04), whereas ε4 was associated with lobar (OR 2.09; p < 0.001) but not nonlobar wICH (p = 0.35). The replication stage (63 wICHs and 1,030 controls) confirmed the association with ε2 (p = 0.03) and ε4 (p = 0.003) for lobar but not for nonlobar wICH (p > 0.20). Genotyping information on APOE ε variants significantly improved case/control discrimination of lobar wICH (C statistic 0.80). No statistical interaction between warfarin and APOE was found (p > 0.20). CONCLUSIONS APOE ε variants constitute strong risk factors for lobar wICH. APOE exerts its effect independently of warfarin, although power limitations render this absence of interaction preliminary. Evaluation of the predictive ability of APOE in cohort studies is warranted.
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Affiliation(s)
- Guido J Falcone
- From the Center for Human Genetic Research (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., V.V., M.R.R., L.P.C., A.M.A., K.S., A.V., S.M.G., A.B., J.R., C.D.A.), J. Philip Kistler Stroke Research Center (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., V.V., M.R.R., A.B., J.R., C.D.A.), Division of Neurocritical Care and Emergency Neurology, Department of Neurology (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., M.R.R., A.B., J.R., C.D.A.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Boston; Program in Medical and Population Genetics (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., M.R.R., A.B., J.R., C.D.A.), Broad Institute, Cambridge, MA; Department of Epidemiology (G.J.F., P.K.), Harvard School of Public Health, Boston; Department of Neurology (M.S.), Beth Israel Deaconess Medical Center, Boston, MA; Department of Neurology (J.F.M.), Mayo Clinic, Jacksonville, FL; Stroke Program (D.L.B.), Department of Neurology, University of Michigan Health System, Ann Arbor; Departments of Neurology and Public Health Sciences (B.B.W.), University of Virginia Health System, Charlottesville; Department of Neurology (S.L.S.), University of Florida College of Medicine, Jacksonville; Stroke Center (D.L.T.), Harborview Medical Center, University of Washington, Seattle; and University of Cincinnati College of Medicine (M.L.F., S.R.M., R.D., D.W.), OH
| | - Farid Radmanesh
- From the Center for Human Genetic Research (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., V.V., M.R.R., L.P.C., A.M.A., K.S., A.V., S.M.G., A.B., J.R., C.D.A.), J. Philip Kistler Stroke Research Center (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., V.V., M.R.R., A.B., J.R., C.D.A.), Division of Neurocritical Care and Emergency Neurology, Department of Neurology (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., M.R.R., A.B., J.R., C.D.A.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Boston; Program in Medical and Population Genetics (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., M.R.R., A.B., J.R., C.D.A.), Broad Institute, Cambridge, MA; Department of Epidemiology (G.J.F., P.K.), Harvard School of Public Health, Boston; Department of Neurology (M.S.), Beth Israel Deaconess Medical Center, Boston, MA; Department of Neurology (J.F.M.), Mayo Clinic, Jacksonville, FL; Stroke Program (D.L.B.), Department of Neurology, University of Michigan Health System, Ann Arbor; Departments of Neurology and Public Health Sciences (B.B.W.), University of Virginia Health System, Charlottesville; Department of Neurology (S.L.S.), University of Florida College of Medicine, Jacksonville; Stroke Center (D.L.T.), Harborview Medical Center, University of Washington, Seattle; and University of Cincinnati College of Medicine (M.L.F., S.R.M., R.D., D.W.), OH
| | - H Bart Brouwers
- From the Center for Human Genetic Research (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., V.V., M.R.R., L.P.C., A.M.A., K.S., A.V., S.M.G., A.B., J.R., C.D.A.), J. Philip Kistler Stroke Research Center (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., V.V., M.R.R., A.B., J.R., C.D.A.), Division of Neurocritical Care and Emergency Neurology, Department of Neurology (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., M.R.R., A.B., J.R., C.D.A.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Boston; Program in Medical and Population Genetics (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., M.R.R., A.B., J.R., C.D.A.), Broad Institute, Cambridge, MA; Department of Epidemiology (G.J.F., P.K.), Harvard School of Public Health, Boston; Department of Neurology (M.S.), Beth Israel Deaconess Medical Center, Boston, MA; Department of Neurology (J.F.M.), Mayo Clinic, Jacksonville, FL; Stroke Program (D.L.B.), Department of Neurology, University of Michigan Health System, Ann Arbor; Departments of Neurology and Public Health Sciences (B.B.W.), University of Virginia Health System, Charlottesville; Department of Neurology (S.L.S.), University of Florida College of Medicine, Jacksonville; Stroke Center (D.L.T.), Harborview Medical Center, University of Washington, Seattle; and University of Cincinnati College of Medicine (M.L.F., S.R.M., R.D., D.W.), OH
| | - Thomas W K Battey
- From the Center for Human Genetic Research (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., V.V., M.R.R., L.P.C., A.M.A., K.S., A.V., S.M.G., A.B., J.R., C.D.A.), J. Philip Kistler Stroke Research Center (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., V.V., M.R.R., A.B., J.R., C.D.A.), Division of Neurocritical Care and Emergency Neurology, Department of Neurology (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., M.R.R., A.B., J.R., C.D.A.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Boston; Program in Medical and Population Genetics (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., M.R.R., A.B., J.R., C.D.A.), Broad Institute, Cambridge, MA; Department of Epidemiology (G.J.F., P.K.), Harvard School of Public Health, Boston; Department of Neurology (M.S.), Beth Israel Deaconess Medical Center, Boston, MA; Department of Neurology (J.F.M.), Mayo Clinic, Jacksonville, FL; Stroke Program (D.L.B.), Department of Neurology, University of Michigan Health System, Ann Arbor; Departments of Neurology and Public Health Sciences (B.B.W.), University of Virginia Health System, Charlottesville; Department of Neurology (S.L.S.), University of Florida College of Medicine, Jacksonville; Stroke Center (D.L.T.), Harborview Medical Center, University of Washington, Seattle; and University of Cincinnati College of Medicine (M.L.F., S.R.M., R.D., D.W.), OH
| | - William J Devan
- From the Center for Human Genetic Research (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., V.V., M.R.R., L.P.C., A.M.A., K.S., A.V., S.M.G., A.B., J.R., C.D.A.), J. Philip Kistler Stroke Research Center (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., V.V., M.R.R., A.B., J.R., C.D.A.), Division of Neurocritical Care and Emergency Neurology, Department of Neurology (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., M.R.R., A.B., J.R., C.D.A.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Boston; Program in Medical and Population Genetics (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., M.R.R., A.B., J.R., C.D.A.), Broad Institute, Cambridge, MA; Department of Epidemiology (G.J.F., P.K.), Harvard School of Public Health, Boston; Department of Neurology (M.S.), Beth Israel Deaconess Medical Center, Boston, MA; Department of Neurology (J.F.M.), Mayo Clinic, Jacksonville, FL; Stroke Program (D.L.B.), Department of Neurology, University of Michigan Health System, Ann Arbor; Departments of Neurology and Public Health Sciences (B.B.W.), University of Virginia Health System, Charlottesville; Department of Neurology (S.L.S.), University of Florida College of Medicine, Jacksonville; Stroke Center (D.L.T.), Harborview Medical Center, University of Washington, Seattle; and University of Cincinnati College of Medicine (M.L.F., S.R.M., R.D., D.W.), OH
| | - Valerie Valant
- From the Center for Human Genetic Research (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., V.V., M.R.R., L.P.C., A.M.A., K.S., A.V., S.M.G., A.B., J.R., C.D.A.), J. Philip Kistler Stroke Research Center (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., V.V., M.R.R., A.B., J.R., C.D.A.), Division of Neurocritical Care and Emergency Neurology, Department of Neurology (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., M.R.R., A.B., J.R., C.D.A.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Boston; Program in Medical and Population Genetics (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., M.R.R., A.B., J.R., C.D.A.), Broad Institute, Cambridge, MA; Department of Epidemiology (G.J.F., P.K.), Harvard School of Public Health, Boston; Department of Neurology (M.S.), Beth Israel Deaconess Medical Center, Boston, MA; Department of Neurology (J.F.M.), Mayo Clinic, Jacksonville, FL; Stroke Program (D.L.B.), Department of Neurology, University of Michigan Health System, Ann Arbor; Departments of Neurology and Public Health Sciences (B.B.W.), University of Virginia Health System, Charlottesville; Department of Neurology (S.L.S.), University of Florida College of Medicine, Jacksonville; Stroke Center (D.L.T.), Harborview Medical Center, University of Washington, Seattle; and University of Cincinnati College of Medicine (M.L.F., S.R.M., R.D., D.W.), OH
| | - Miriam R Raffeld
- From the Center for Human Genetic Research (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., V.V., M.R.R., L.P.C., A.M.A., K.S., A.V., S.M.G., A.B., J.R., C.D.A.), J. Philip Kistler Stroke Research Center (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., V.V., M.R.R., A.B., J.R., C.D.A.), Division of Neurocritical Care and Emergency Neurology, Department of Neurology (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., M.R.R., A.B., J.R., C.D.A.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Boston; Program in Medical and Population Genetics (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., M.R.R., A.B., J.R., C.D.A.), Broad Institute, Cambridge, MA; Department of Epidemiology (G.J.F., P.K.), Harvard School of Public Health, Boston; Department of Neurology (M.S.), Beth Israel Deaconess Medical Center, Boston, MA; Department of Neurology (J.F.M.), Mayo Clinic, Jacksonville, FL; Stroke Program (D.L.B.), Department of Neurology, University of Michigan Health System, Ann Arbor; Departments of Neurology and Public Health Sciences (B.B.W.), University of Virginia Health System, Charlottesville; Department of Neurology (S.L.S.), University of Florida College of Medicine, Jacksonville; Stroke Center (D.L.T.), Harborview Medical Center, University of Washington, Seattle; and University of Cincinnati College of Medicine (M.L.F., S.R.M., R.D., D.W.), OH
| | - Lennox P Chitsike
- From the Center for Human Genetic Research (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., V.V., M.R.R., L.P.C., A.M.A., K.S., A.V., S.M.G., A.B., J.R., C.D.A.), J. Philip Kistler Stroke Research Center (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., V.V., M.R.R., A.B., J.R., C.D.A.), Division of Neurocritical Care and Emergency Neurology, Department of Neurology (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., M.R.R., A.B., J.R., C.D.A.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Boston; Program in Medical and Population Genetics (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., M.R.R., A.B., J.R., C.D.A.), Broad Institute, Cambridge, MA; Department of Epidemiology (G.J.F., P.K.), Harvard School of Public Health, Boston; Department of Neurology (M.S.), Beth Israel Deaconess Medical Center, Boston, MA; Department of Neurology (J.F.M.), Mayo Clinic, Jacksonville, FL; Stroke Program (D.L.B.), Department of Neurology, University of Michigan Health System, Ann Arbor; Departments of Neurology and Public Health Sciences (B.B.W.), University of Virginia Health System, Charlottesville; Department of Neurology (S.L.S.), University of Florida College of Medicine, Jacksonville; Stroke Center (D.L.T.), Harborview Medical Center, University of Washington, Seattle; and University of Cincinnati College of Medicine (M.L.F., S.R.M., R.D., D.W.), OH
| | - Alison M Ayres
- From the Center for Human Genetic Research (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., V.V., M.R.R., L.P.C., A.M.A., K.S., A.V., S.M.G., A.B., J.R., C.D.A.), J. Philip Kistler Stroke Research Center (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., V.V., M.R.R., A.B., J.R., C.D.A.), Division of Neurocritical Care and Emergency Neurology, Department of Neurology (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., M.R.R., A.B., J.R., C.D.A.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Boston; Program in Medical and Population Genetics (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., M.R.R., A.B., J.R., C.D.A.), Broad Institute, Cambridge, MA; Department of Epidemiology (G.J.F., P.K.), Harvard School of Public Health, Boston; Department of Neurology (M.S.), Beth Israel Deaconess Medical Center, Boston, MA; Department of Neurology (J.F.M.), Mayo Clinic, Jacksonville, FL; Stroke Program (D.L.B.), Department of Neurology, University of Michigan Health System, Ann Arbor; Departments of Neurology and Public Health Sciences (B.B.W.), University of Virginia Health System, Charlottesville; Department of Neurology (S.L.S.), University of Florida College of Medicine, Jacksonville; Stroke Center (D.L.T.), Harborview Medical Center, University of Washington, Seattle; and University of Cincinnati College of Medicine (M.L.F., S.R.M., R.D., D.W.), OH
| | - Kristin Schwab
- From the Center for Human Genetic Research (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., V.V., M.R.R., L.P.C., A.M.A., K.S., A.V., S.M.G., A.B., J.R., C.D.A.), J. Philip Kistler Stroke Research Center (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., V.V., M.R.R., A.B., J.R., C.D.A.), Division of Neurocritical Care and Emergency Neurology, Department of Neurology (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., M.R.R., A.B., J.R., C.D.A.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Boston; Program in Medical and Population Genetics (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., M.R.R., A.B., J.R., C.D.A.), Broad Institute, Cambridge, MA; Department of Epidemiology (G.J.F., P.K.), Harvard School of Public Health, Boston; Department of Neurology (M.S.), Beth Israel Deaconess Medical Center, Boston, MA; Department of Neurology (J.F.M.), Mayo Clinic, Jacksonville, FL; Stroke Program (D.L.B.), Department of Neurology, University of Michigan Health System, Ann Arbor; Departments of Neurology and Public Health Sciences (B.B.W.), University of Virginia Health System, Charlottesville; Department of Neurology (S.L.S.), University of Florida College of Medicine, Jacksonville; Stroke Center (D.L.T.), Harborview Medical Center, University of Washington, Seattle; and University of Cincinnati College of Medicine (M.L.F., S.R.M., R.D., D.W.), OH
| | - Joshua N Goldstein
- From the Center for Human Genetic Research (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., V.V., M.R.R., L.P.C., A.M.A., K.S., A.V., S.M.G., A.B., J.R., C.D.A.), J. Philip Kistler Stroke Research Center (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., V.V., M.R.R., A.B., J.R., C.D.A.), Division of Neurocritical Care and Emergency Neurology, Department of Neurology (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., M.R.R., A.B., J.R., C.D.A.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Boston; Program in Medical and Population Genetics (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., M.R.R., A.B., J.R., C.D.A.), Broad Institute, Cambridge, MA; Department of Epidemiology (G.J.F., P.K.), Harvard School of Public Health, Boston; Department of Neurology (M.S.), Beth Israel Deaconess Medical Center, Boston, MA; Department of Neurology (J.F.M.), Mayo Clinic, Jacksonville, FL; Stroke Program (D.L.B.), Department of Neurology, University of Michigan Health System, Ann Arbor; Departments of Neurology and Public Health Sciences (B.B.W.), University of Virginia Health System, Charlottesville; Department of Neurology (S.L.S.), University of Florida College of Medicine, Jacksonville; Stroke Center (D.L.T.), Harborview Medical Center, University of Washington, Seattle; and University of Cincinnati College of Medicine (M.L.F., S.R.M., R.D., D.W.), OH
| | - Anand Viswanathan
- From the Center for Human Genetic Research (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., V.V., M.R.R., L.P.C., A.M.A., K.S., A.V., S.M.G., A.B., J.R., C.D.A.), J. Philip Kistler Stroke Research Center (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., V.V., M.R.R., A.B., J.R., C.D.A.), Division of Neurocritical Care and Emergency Neurology, Department of Neurology (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., M.R.R., A.B., J.R., C.D.A.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Boston; Program in Medical and Population Genetics (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., M.R.R., A.B., J.R., C.D.A.), Broad Institute, Cambridge, MA; Department of Epidemiology (G.J.F., P.K.), Harvard School of Public Health, Boston; Department of Neurology (M.S.), Beth Israel Deaconess Medical Center, Boston, MA; Department of Neurology (J.F.M.), Mayo Clinic, Jacksonville, FL; Stroke Program (D.L.B.), Department of Neurology, University of Michigan Health System, Ann Arbor; Departments of Neurology and Public Health Sciences (B.B.W.), University of Virginia Health System, Charlottesville; Department of Neurology (S.L.S.), University of Florida College of Medicine, Jacksonville; Stroke Center (D.L.T.), Harborview Medical Center, University of Washington, Seattle; and University of Cincinnati College of Medicine (M.L.F., S.R.M., R.D., D.W.), OH
| | - Steven M Greenberg
- From the Center for Human Genetic Research (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., V.V., M.R.R., L.P.C., A.M.A., K.S., A.V., S.M.G., A.B., J.R., C.D.A.), J. Philip Kistler Stroke Research Center (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., V.V., M.R.R., A.B., J.R., C.D.A.), Division of Neurocritical Care and Emergency Neurology, Department of Neurology (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., M.R.R., A.B., J.R., C.D.A.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Boston; Program in Medical and Population Genetics (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., M.R.R., A.B., J.R., C.D.A.), Broad Institute, Cambridge, MA; Department of Epidemiology (G.J.F., P.K.), Harvard School of Public Health, Boston; Department of Neurology (M.S.), Beth Israel Deaconess Medical Center, Boston, MA; Department of Neurology (J.F.M.), Mayo Clinic, Jacksonville, FL; Stroke Program (D.L.B.), Department of Neurology, University of Michigan Health System, Ann Arbor; Departments of Neurology and Public Health Sciences (B.B.W.), University of Virginia Health System, Charlottesville; Department of Neurology (S.L.S.), University of Florida College of Medicine, Jacksonville; Stroke Center (D.L.T.), Harborview Medical Center, University of Washington, Seattle; and University of Cincinnati College of Medicine (M.L.F., S.R.M., R.D., D.W.), OH
| | - Magdy Selim
- From the Center for Human Genetic Research (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., V.V., M.R.R., L.P.C., A.M.A., K.S., A.V., S.M.G., A.B., J.R., C.D.A.), J. Philip Kistler Stroke Research Center (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., V.V., M.R.R., A.B., J.R., C.D.A.), Division of Neurocritical Care and Emergency Neurology, Department of Neurology (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., M.R.R., A.B., J.R., C.D.A.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Boston; Program in Medical and Population Genetics (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., M.R.R., A.B., J.R., C.D.A.), Broad Institute, Cambridge, MA; Department of Epidemiology (G.J.F., P.K.), Harvard School of Public Health, Boston; Department of Neurology (M.S.), Beth Israel Deaconess Medical Center, Boston, MA; Department of Neurology (J.F.M.), Mayo Clinic, Jacksonville, FL; Stroke Program (D.L.B.), Department of Neurology, University of Michigan Health System, Ann Arbor; Departments of Neurology and Public Health Sciences (B.B.W.), University of Virginia Health System, Charlottesville; Department of Neurology (S.L.S.), University of Florida College of Medicine, Jacksonville; Stroke Center (D.L.T.), Harborview Medical Center, University of Washington, Seattle; and University of Cincinnati College of Medicine (M.L.F., S.R.M., R.D., D.W.), OH
| | - James F Meschia
- From the Center for Human Genetic Research (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., V.V., M.R.R., L.P.C., A.M.A., K.S., A.V., S.M.G., A.B., J.R., C.D.A.), J. Philip Kistler Stroke Research Center (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., V.V., M.R.R., A.B., J.R., C.D.A.), Division of Neurocritical Care and Emergency Neurology, Department of Neurology (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., M.R.R., A.B., J.R., C.D.A.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Boston; Program in Medical and Population Genetics (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., M.R.R., A.B., J.R., C.D.A.), Broad Institute, Cambridge, MA; Department of Epidemiology (G.J.F., P.K.), Harvard School of Public Health, Boston; Department of Neurology (M.S.), Beth Israel Deaconess Medical Center, Boston, MA; Department of Neurology (J.F.M.), Mayo Clinic, Jacksonville, FL; Stroke Program (D.L.B.), Department of Neurology, University of Michigan Health System, Ann Arbor; Departments of Neurology and Public Health Sciences (B.B.W.), University of Virginia Health System, Charlottesville; Department of Neurology (S.L.S.), University of Florida College of Medicine, Jacksonville; Stroke Center (D.L.T.), Harborview Medical Center, University of Washington, Seattle; and University of Cincinnati College of Medicine (M.L.F., S.R.M., R.D., D.W.), OH
| | - Devin L Brown
- From the Center for Human Genetic Research (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., V.V., M.R.R., L.P.C., A.M.A., K.S., A.V., S.M.G., A.B., J.R., C.D.A.), J. Philip Kistler Stroke Research Center (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., V.V., M.R.R., A.B., J.R., C.D.A.), Division of Neurocritical Care and Emergency Neurology, Department of Neurology (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., M.R.R., A.B., J.R., C.D.A.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Boston; Program in Medical and Population Genetics (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., M.R.R., A.B., J.R., C.D.A.), Broad Institute, Cambridge, MA; Department of Epidemiology (G.J.F., P.K.), Harvard School of Public Health, Boston; Department of Neurology (M.S.), Beth Israel Deaconess Medical Center, Boston, MA; Department of Neurology (J.F.M.), Mayo Clinic, Jacksonville, FL; Stroke Program (D.L.B.), Department of Neurology, University of Michigan Health System, Ann Arbor; Departments of Neurology and Public Health Sciences (B.B.W.), University of Virginia Health System, Charlottesville; Department of Neurology (S.L.S.), University of Florida College of Medicine, Jacksonville; Stroke Center (D.L.T.), Harborview Medical Center, University of Washington, Seattle; and University of Cincinnati College of Medicine (M.L.F., S.R.M., R.D., D.W.), OH
| | - Bradford B Worrall
- From the Center for Human Genetic Research (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., V.V., M.R.R., L.P.C., A.M.A., K.S., A.V., S.M.G., A.B., J.R., C.D.A.), J. Philip Kistler Stroke Research Center (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., V.V., M.R.R., A.B., J.R., C.D.A.), Division of Neurocritical Care and Emergency Neurology, Department of Neurology (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., M.R.R., A.B., J.R., C.D.A.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Boston; Program in Medical and Population Genetics (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., M.R.R., A.B., J.R., C.D.A.), Broad Institute, Cambridge, MA; Department of Epidemiology (G.J.F., P.K.), Harvard School of Public Health, Boston; Department of Neurology (M.S.), Beth Israel Deaconess Medical Center, Boston, MA; Department of Neurology (J.F.M.), Mayo Clinic, Jacksonville, FL; Stroke Program (D.L.B.), Department of Neurology, University of Michigan Health System, Ann Arbor; Departments of Neurology and Public Health Sciences (B.B.W.), University of Virginia Health System, Charlottesville; Department of Neurology (S.L.S.), University of Florida College of Medicine, Jacksonville; Stroke Center (D.L.T.), Harborview Medical Center, University of Washington, Seattle; and University of Cincinnati College of Medicine (M.L.F., S.R.M., R.D., D.W.), OH
| | - Scott L Silliman
- From the Center for Human Genetic Research (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., V.V., M.R.R., L.P.C., A.M.A., K.S., A.V., S.M.G., A.B., J.R., C.D.A.), J. Philip Kistler Stroke Research Center (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., V.V., M.R.R., A.B., J.R., C.D.A.), Division of Neurocritical Care and Emergency Neurology, Department of Neurology (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., M.R.R., A.B., J.R., C.D.A.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Boston; Program in Medical and Population Genetics (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., M.R.R., A.B., J.R., C.D.A.), Broad Institute, Cambridge, MA; Department of Epidemiology (G.J.F., P.K.), Harvard School of Public Health, Boston; Department of Neurology (M.S.), Beth Israel Deaconess Medical Center, Boston, MA; Department of Neurology (J.F.M.), Mayo Clinic, Jacksonville, FL; Stroke Program (D.L.B.), Department of Neurology, University of Michigan Health System, Ann Arbor; Departments of Neurology and Public Health Sciences (B.B.W.), University of Virginia Health System, Charlottesville; Department of Neurology (S.L.S.), University of Florida College of Medicine, Jacksonville; Stroke Center (D.L.T.), Harborview Medical Center, University of Washington, Seattle; and University of Cincinnati College of Medicine (M.L.F., S.R.M., R.D., D.W.), OH
| | - David L Tirschwell
- From the Center for Human Genetic Research (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., V.V., M.R.R., L.P.C., A.M.A., K.S., A.V., S.M.G., A.B., J.R., C.D.A.), J. Philip Kistler Stroke Research Center (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., V.V., M.R.R., A.B., J.R., C.D.A.), Division of Neurocritical Care and Emergency Neurology, Department of Neurology (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., M.R.R., A.B., J.R., C.D.A.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Boston; Program in Medical and Population Genetics (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., M.R.R., A.B., J.R., C.D.A.), Broad Institute, Cambridge, MA; Department of Epidemiology (G.J.F., P.K.), Harvard School of Public Health, Boston; Department of Neurology (M.S.), Beth Israel Deaconess Medical Center, Boston, MA; Department of Neurology (J.F.M.), Mayo Clinic, Jacksonville, FL; Stroke Program (D.L.B.), Department of Neurology, University of Michigan Health System, Ann Arbor; Departments of Neurology and Public Health Sciences (B.B.W.), University of Virginia Health System, Charlottesville; Department of Neurology (S.L.S.), University of Florida College of Medicine, Jacksonville; Stroke Center (D.L.T.), Harborview Medical Center, University of Washington, Seattle; and University of Cincinnati College of Medicine (M.L.F., S.R.M., R.D., D.W.), OH
| | - Matthew L Flaherty
- From the Center for Human Genetic Research (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., V.V., M.R.R., L.P.C., A.M.A., K.S., A.V., S.M.G., A.B., J.R., C.D.A.), J. Philip Kistler Stroke Research Center (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., V.V., M.R.R., A.B., J.R., C.D.A.), Division of Neurocritical Care and Emergency Neurology, Department of Neurology (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., M.R.R., A.B., J.R., C.D.A.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Boston; Program in Medical and Population Genetics (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., M.R.R., A.B., J.R., C.D.A.), Broad Institute, Cambridge, MA; Department of Epidemiology (G.J.F., P.K.), Harvard School of Public Health, Boston; Department of Neurology (M.S.), Beth Israel Deaconess Medical Center, Boston, MA; Department of Neurology (J.F.M.), Mayo Clinic, Jacksonville, FL; Stroke Program (D.L.B.), Department of Neurology, University of Michigan Health System, Ann Arbor; Departments of Neurology and Public Health Sciences (B.B.W.), University of Virginia Health System, Charlottesville; Department of Neurology (S.L.S.), University of Florida College of Medicine, Jacksonville; Stroke Center (D.L.T.), Harborview Medical Center, University of Washington, Seattle; and University of Cincinnati College of Medicine (M.L.F., S.R.M., R.D., D.W.), OH
| | - Sharyl R Martini
- From the Center for Human Genetic Research (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., V.V., M.R.R., L.P.C., A.M.A., K.S., A.V., S.M.G., A.B., J.R., C.D.A.), J. Philip Kistler Stroke Research Center (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., V.V., M.R.R., A.B., J.R., C.D.A.), Division of Neurocritical Care and Emergency Neurology, Department of Neurology (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., M.R.R., A.B., J.R., C.D.A.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Boston; Program in Medical and Population Genetics (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., M.R.R., A.B., J.R., C.D.A.), Broad Institute, Cambridge, MA; Department of Epidemiology (G.J.F., P.K.), Harvard School of Public Health, Boston; Department of Neurology (M.S.), Beth Israel Deaconess Medical Center, Boston, MA; Department of Neurology (J.F.M.), Mayo Clinic, Jacksonville, FL; Stroke Program (D.L.B.), Department of Neurology, University of Michigan Health System, Ann Arbor; Departments of Neurology and Public Health Sciences (B.B.W.), University of Virginia Health System, Charlottesville; Department of Neurology (S.L.S.), University of Florida College of Medicine, Jacksonville; Stroke Center (D.L.T.), Harborview Medical Center, University of Washington, Seattle; and University of Cincinnati College of Medicine (M.L.F., S.R.M., R.D., D.W.), OH
| | - Ranjan Deka
- From the Center for Human Genetic Research (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., V.V., M.R.R., L.P.C., A.M.A., K.S., A.V., S.M.G., A.B., J.R., C.D.A.), J. Philip Kistler Stroke Research Center (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., V.V., M.R.R., A.B., J.R., C.D.A.), Division of Neurocritical Care and Emergency Neurology, Department of Neurology (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., M.R.R., A.B., J.R., C.D.A.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Boston; Program in Medical and Population Genetics (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., M.R.R., A.B., J.R., C.D.A.), Broad Institute, Cambridge, MA; Department of Epidemiology (G.J.F., P.K.), Harvard School of Public Health, Boston; Department of Neurology (M.S.), Beth Israel Deaconess Medical Center, Boston, MA; Department of Neurology (J.F.M.), Mayo Clinic, Jacksonville, FL; Stroke Program (D.L.B.), Department of Neurology, University of Michigan Health System, Ann Arbor; Departments of Neurology and Public Health Sciences (B.B.W.), University of Virginia Health System, Charlottesville; Department of Neurology (S.L.S.), University of Florida College of Medicine, Jacksonville; Stroke Center (D.L.T.), Harborview Medical Center, University of Washington, Seattle; and University of Cincinnati College of Medicine (M.L.F., S.R.M., R.D., D.W.), OH
| | - Alessandro Biffi
- From the Center for Human Genetic Research (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., V.V., M.R.R., L.P.C., A.M.A., K.S., A.V., S.M.G., A.B., J.R., C.D.A.), J. Philip Kistler Stroke Research Center (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., V.V., M.R.R., A.B., J.R., C.D.A.), Division of Neurocritical Care and Emergency Neurology, Department of Neurology (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., M.R.R., A.B., J.R., C.D.A.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Boston; Program in Medical and Population Genetics (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., M.R.R., A.B., J.R., C.D.A.), Broad Institute, Cambridge, MA; Department of Epidemiology (G.J.F., P.K.), Harvard School of Public Health, Boston; Department of Neurology (M.S.), Beth Israel Deaconess Medical Center, Boston, MA; Department of Neurology (J.F.M.), Mayo Clinic, Jacksonville, FL; Stroke Program (D.L.B.), Department of Neurology, University of Michigan Health System, Ann Arbor; Departments of Neurology and Public Health Sciences (B.B.W.), University of Virginia Health System, Charlottesville; Department of Neurology (S.L.S.), University of Florida College of Medicine, Jacksonville; Stroke Center (D.L.T.), Harborview Medical Center, University of Washington, Seattle; and University of Cincinnati College of Medicine (M.L.F., S.R.M., R.D., D.W.), OH
| | - Peter Kraft
- From the Center for Human Genetic Research (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., V.V., M.R.R., L.P.C., A.M.A., K.S., A.V., S.M.G., A.B., J.R., C.D.A.), J. Philip Kistler Stroke Research Center (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., V.V., M.R.R., A.B., J.R., C.D.A.), Division of Neurocritical Care and Emergency Neurology, Department of Neurology (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., M.R.R., A.B., J.R., C.D.A.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Boston; Program in Medical and Population Genetics (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., M.R.R., A.B., J.R., C.D.A.), Broad Institute, Cambridge, MA; Department of Epidemiology (G.J.F., P.K.), Harvard School of Public Health, Boston; Department of Neurology (M.S.), Beth Israel Deaconess Medical Center, Boston, MA; Department of Neurology (J.F.M.), Mayo Clinic, Jacksonville, FL; Stroke Program (D.L.B.), Department of Neurology, University of Michigan Health System, Ann Arbor; Departments of Neurology and Public Health Sciences (B.B.W.), University of Virginia Health System, Charlottesville; Department of Neurology (S.L.S.), University of Florida College of Medicine, Jacksonville; Stroke Center (D.L.T.), Harborview Medical Center, University of Washington, Seattle; and University of Cincinnati College of Medicine (M.L.F., S.R.M., R.D., D.W.), OH
| | - Daniel Woo
- From the Center for Human Genetic Research (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., V.V., M.R.R., L.P.C., A.M.A., K.S., A.V., S.M.G., A.B., J.R., C.D.A.), J. Philip Kistler Stroke Research Center (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., V.V., M.R.R., A.B., J.R., C.D.A.), Division of Neurocritical Care and Emergency Neurology, Department of Neurology (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., M.R.R., A.B., J.R., C.D.A.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Boston; Program in Medical and Population Genetics (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., M.R.R., A.B., J.R., C.D.A.), Broad Institute, Cambridge, MA; Department of Epidemiology (G.J.F., P.K.), Harvard School of Public Health, Boston; Department of Neurology (M.S.), Beth Israel Deaconess Medical Center, Boston, MA; Department of Neurology (J.F.M.), Mayo Clinic, Jacksonville, FL; Stroke Program (D.L.B.), Department of Neurology, University of Michigan Health System, Ann Arbor; Departments of Neurology and Public Health Sciences (B.B.W.), University of Virginia Health System, Charlottesville; Department of Neurology (S.L.S.), University of Florida College of Medicine, Jacksonville; Stroke Center (D.L.T.), Harborview Medical Center, University of Washington, Seattle; and University of Cincinnati College of Medicine (M.L.F., S.R.M., R.D., D.W.), OH
| | - Jonathan Rosand
- From the Center for Human Genetic Research (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., V.V., M.R.R., L.P.C., A.M.A., K.S., A.V., S.M.G., A.B., J.R., C.D.A.), J. Philip Kistler Stroke Research Center (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., V.V., M.R.R., A.B., J.R., C.D.A.), Division of Neurocritical Care and Emergency Neurology, Department of Neurology (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., M.R.R., A.B., J.R., C.D.A.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Boston; Program in Medical and Population Genetics (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., M.R.R., A.B., J.R., C.D.A.), Broad Institute, Cambridge, MA; Department of Epidemiology (G.J.F., P.K.), Harvard School of Public Health, Boston; Department of Neurology (M.S.), Beth Israel Deaconess Medical Center, Boston, MA; Department of Neurology (J.F.M.), Mayo Clinic, Jacksonville, FL; Stroke Program (D.L.B.), Department of Neurology, University of Michigan Health System, Ann Arbor; Departments of Neurology and Public Health Sciences (B.B.W.), University of Virginia Health System, Charlottesville; Department of Neurology (S.L.S.), University of Florida College of Medicine, Jacksonville; Stroke Center (D.L.T.), Harborview Medical Center, University of Washington, Seattle; and University of Cincinnati College of Medicine (M.L.F., S.R.M., R.D., D.W.), OH
| | - Christopher D Anderson
- From the Center for Human Genetic Research (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., V.V., M.R.R., L.P.C., A.M.A., K.S., A.V., S.M.G., A.B., J.R., C.D.A.), J. Philip Kistler Stroke Research Center (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., V.V., M.R.R., A.B., J.R., C.D.A.), Division of Neurocritical Care and Emergency Neurology, Department of Neurology (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., M.R.R., A.B., J.R., C.D.A.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Boston; Program in Medical and Population Genetics (G.J.F., F.R., H.B.B., T.W.K.B., W.J.D., M.R.R., A.B., J.R., C.D.A.), Broad Institute, Cambridge, MA; Department of Epidemiology (G.J.F., P.K.), Harvard School of Public Health, Boston; Department of Neurology (M.S.), Beth Israel Deaconess Medical Center, Boston, MA; Department of Neurology (J.F.M.), Mayo Clinic, Jacksonville, FL; Stroke Program (D.L.B.), Department of Neurology, University of Michigan Health System, Ann Arbor; Departments of Neurology and Public Health Sciences (B.B.W.), University of Virginia Health System, Charlottesville; Department of Neurology (S.L.S.), University of Florida College of Medicine, Jacksonville; Stroke Center (D.L.T.), Harborview Medical Center, University of Washington, Seattle; and University of Cincinnati College of Medicine (M.L.F., S.R.M., R.D., D.W.), OH.
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Woo D, Falcone GJ, Devan WJ, Brown WM, Biffi A, Howard TD, Anderson CD, Brouwers HB, Valant V, Battey TWK, Radmanesh F, Raffeld MR, Baedorf-Kassis S, Deka R, Woo JG, Martin LJ, Haverbusch M, Moomaw CJ, Sun G, Broderick JP, Flaherty ML, Martini SR, Kleindorfer DO, Kissela B, Comeau ME, Jagiella JM, Schmidt H, Freudenberger P, Pichler A, Enzinger C, Hansen BM, Norrving B, Jimenez-Conde J, Giralt-Steinhauer E, Elosua R, Cuadrado-Godia E, Soriano C, Roquer J, Kraft P, Ayres AM, Schwab K, McCauley JL, Pera J, Urbanik A, Rost NS, Goldstein JN, Viswanathan A, Stögerer EM, Tirschwell DL, Selim M, Brown DL, Silliman SL, Worrall BB, Meschia JF, Kidwell CS, Montaner J, Fernandez-Cadenas I, Delgado P, Malik R, Dichgans M, Greenberg SM, Rothwell PM, Lindgren A, Slowik A, Schmidt R, Langefeld CD, Rosand J. Meta-analysis of genome-wide association studies identifies 1q22 as a susceptibility locus for intracerebral hemorrhage. Am J Hum Genet 2014; 94:511-21. [PMID: 24656865 PMCID: PMC3980413 DOI: 10.1016/j.ajhg.2014.02.012] [Citation(s) in RCA: 204] [Impact Index Per Article: 20.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2013] [Accepted: 02/24/2014] [Indexed: 11/25/2022] Open
Abstract
Intracerebral hemorrhage (ICH) is the stroke subtype with the worst prognosis and has no established acute treatment. ICH is classified as lobar or nonlobar based on the location of ruptured blood vessels within the brain. These different locations also signal different underlying vascular pathologies. Heritability estimates indicate a substantial genetic contribution to risk of ICH in both locations. We report a genome-wide association study of this condition that meta-analyzed data from six studies that enrolled individuals of European ancestry. Case subjects were ascertained by neurologists blinded to genotype data and classified as lobar or nonlobar based on brain computed tomography. ICH-free control subjects were sampled from ambulatory clinics or random digit dialing. Replication of signals identified in the discovery cohort with p < 1 × 10(-6) was pursued in an independent multiethnic sample utilizing both direct and genome-wide genotyping. The discovery phase included a case cohort of 1,545 individuals (664 lobar and 881 nonlobar cases) and a control cohort of 1,481 individuals and identified two susceptibility loci: for lobar ICH, chromosomal region 12q21.1 (rs11179580, odds ratio [OR] = 1.56, p = 7.0 × 10(-8)); and for nonlobar ICH, chromosomal region 1q22 (rs2984613, OR = 1.44, p = 1.6 × 10(-8)). The replication included a case cohort of 1,681 individuals (484 lobar and 1,194 nonlobar cases) and a control cohort of 2,261 individuals and corroborated the association for 1q22 (p = 6.5 × 10(-4); meta-analysis p = 2.2 × 10(-10)) but not for 12q21.1 (p = 0.55; meta-analysis p = 2.6 × 10(-5)). These results demonstrate biological heterogeneity across ICH subtypes and highlight the importance of ascertaining ICH cases accordingly.
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Affiliation(s)
- Daniel Woo
- Department of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA.
| | - Guido J Falcone
- Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA 02114, USA; Division of Neurocritical Care and Emergency Neurology, Department of Neurology, Massachusetts General Hospital, Boston, MA 02114, USA; The J. Philip Kistler Stroke Research Center, Massachusetts General Hospital, Boston, MA 02114, USA; Program in Medical and Population Genetics, Broad Institute, Cambridge, MA 02141, USA; Department of Epidemiology, Harvard School of Public Health, Boston, MA 02115, USA
| | - William J Devan
- Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA 02114, USA; Division of Neurocritical Care and Emergency Neurology, Department of Neurology, Massachusetts General Hospital, Boston, MA 02114, USA; The J. Philip Kistler Stroke Research Center, Massachusetts General Hospital, Boston, MA 02114, USA; Program in Medical and Population Genetics, Broad Institute, Cambridge, MA 02141, USA
| | - W Mark Brown
- Center for Public Health Genomics and Department of Biostatistical Sciences, Wake Forest University, Winston-Salem, NC 27157, USA
| | - Alessandro Biffi
- Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA 02114, USA; Division of Neurocritical Care and Emergency Neurology, Department of Neurology, Massachusetts General Hospital, Boston, MA 02114, USA; The J. Philip Kistler Stroke Research Center, Massachusetts General Hospital, Boston, MA 02114, USA; Program in Medical and Population Genetics, Broad Institute, Cambridge, MA 02141, USA
| | - Timothy D Howard
- Center for Public Health Genomics and Department of Biostatistical Sciences, Wake Forest University, Winston-Salem, NC 27157, USA
| | - Christopher D Anderson
- Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA 02114, USA; Division of Neurocritical Care and Emergency Neurology, Department of Neurology, Massachusetts General Hospital, Boston, MA 02114, USA; The J. Philip Kistler Stroke Research Center, Massachusetts General Hospital, Boston, MA 02114, USA; Program in Medical and Population Genetics, Broad Institute, Cambridge, MA 02141, USA
| | - H Bart Brouwers
- Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA 02114, USA; Division of Neurocritical Care and Emergency Neurology, Department of Neurology, Massachusetts General Hospital, Boston, MA 02114, USA; The J. Philip Kistler Stroke Research Center, Massachusetts General Hospital, Boston, MA 02114, USA; Program in Medical and Population Genetics, Broad Institute, Cambridge, MA 02141, USA
| | - Valerie Valant
- Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA 02114, USA; Division of Neurocritical Care and Emergency Neurology, Department of Neurology, Massachusetts General Hospital, Boston, MA 02114, USA; The J. Philip Kistler Stroke Research Center, Massachusetts General Hospital, Boston, MA 02114, USA; Program in Medical and Population Genetics, Broad Institute, Cambridge, MA 02141, USA
| | - Thomas W K Battey
- Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA 02114, USA; Division of Neurocritical Care and Emergency Neurology, Department of Neurology, Massachusetts General Hospital, Boston, MA 02114, USA; The J. Philip Kistler Stroke Research Center, Massachusetts General Hospital, Boston, MA 02114, USA; Program in Medical and Population Genetics, Broad Institute, Cambridge, MA 02141, USA
| | - Farid Radmanesh
- Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA 02114, USA; Division of Neurocritical Care and Emergency Neurology, Department of Neurology, Massachusetts General Hospital, Boston, MA 02114, USA; The J. Philip Kistler Stroke Research Center, Massachusetts General Hospital, Boston, MA 02114, USA; Program in Medical and Population Genetics, Broad Institute, Cambridge, MA 02141, USA
| | - Miriam R Raffeld
- Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA 02114, USA; Division of Neurocritical Care and Emergency Neurology, Department of Neurology, Massachusetts General Hospital, Boston, MA 02114, USA; The J. Philip Kistler Stroke Research Center, Massachusetts General Hospital, Boston, MA 02114, USA; Program in Medical and Population Genetics, Broad Institute, Cambridge, MA 02141, USA
| | - Sylvia Baedorf-Kassis
- Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA 02114, USA; Division of Neurocritical Care and Emergency Neurology, Department of Neurology, Massachusetts General Hospital, Boston, MA 02114, USA; The J. Philip Kistler Stroke Research Center, Massachusetts General Hospital, Boston, MA 02114, USA; Program in Medical and Population Genetics, Broad Institute, Cambridge, MA 02141, USA
| | - Ranjan Deka
- Department of Environmental Health, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA
| | - Jessica G Woo
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA
| | - Lisa J Martin
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA
| | - Mary Haverbusch
- Department of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA
| | - Charles J Moomaw
- Department of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA
| | - Guangyun Sun
- Department of Environmental Health, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA
| | - Joseph P Broderick
- Department of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA
| | - Matthew L Flaherty
- Department of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA
| | - Sharyl R Martini
- Department of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA
| | - Dawn O Kleindorfer
- Department of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA
| | - Brett Kissela
- Department of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA
| | - Mary E Comeau
- Center for Public Health Genomics and Department of Biostatistical Sciences, Wake Forest University, Winston-Salem, NC 27157, USA
| | - Jeremiasz M Jagiella
- Department of Neurology, Jagiellonian University Medical College, Krakow 31-008, Poland
| | - Helena Schmidt
- Institute of Molecular Biology and Medical Biochemistry, Medical University Graz, Graz 8010, Austria
| | - Paul Freudenberger
- Institute of Molecular Biology and Medical Biochemistry, Medical University Graz, Graz 8010, Austria
| | - Alexander Pichler
- Department of Neurology, Medical University of Graz, Graz 8036, Austria
| | - Christian Enzinger
- Department of Neurology, Medical University of Graz, Graz 8036, Austria; Division of Neuroradiology, Department of Radiology, Medical University of Graz, Graz 8036, Austria
| | - Björn M Hansen
- Department of Clinical Sciences Lund, Neurology, Lund University, Lund 221 85, Sweden; Department of Neurology, Skåne University Hospital, Lund 221 85, Sweden
| | - Bo Norrving
- Department of Clinical Sciences Lund, Neurology, Lund University, Lund 221 85, Sweden; Department of Neurology, Skåne University Hospital, Lund 221 85, Sweden
| | - Jordi Jimenez-Conde
- Department of Neurology, Neurovascular Research Unit, Institut Hospital del Mar d'Investigacions Mèdiques, Universitat Autonoma de Barcelona/DCEXS-UPF, Barcelona 08003, Spain; Cardiovascular Epidemiology and Genetics Research Group, Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona 08003, Spain
| | - Eva Giralt-Steinhauer
- Department of Neurology, Neurovascular Research Unit, Institut Hospital del Mar d'Investigacions Mèdiques, Universitat Autonoma de Barcelona/DCEXS-UPF, Barcelona 08003, Spain; Cardiovascular Epidemiology and Genetics Research Group, Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona 08003, Spain
| | - Roberto Elosua
- Department of Neurology, Neurovascular Research Unit, Institut Hospital del Mar d'Investigacions Mèdiques, Universitat Autonoma de Barcelona/DCEXS-UPF, Barcelona 08003, Spain; Cardiovascular Epidemiology and Genetics Research Group, Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona 08003, Spain
| | - Elisa Cuadrado-Godia
- Department of Neurology, Neurovascular Research Unit, Institut Hospital del Mar d'Investigacions Mèdiques, Universitat Autonoma de Barcelona/DCEXS-UPF, Barcelona 08003, Spain; Cardiovascular Epidemiology and Genetics Research Group, Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona 08003, Spain
| | - Carolina Soriano
- Department of Neurology, Neurovascular Research Unit, Institut Hospital del Mar d'Investigacions Mèdiques, Universitat Autonoma de Barcelona/DCEXS-UPF, Barcelona 08003, Spain; Cardiovascular Epidemiology and Genetics Research Group, Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona 08003, Spain
| | - Jaume Roquer
- Department of Neurology, Neurovascular Research Unit, Institut Hospital del Mar d'Investigacions Mèdiques, Universitat Autonoma de Barcelona/DCEXS-UPF, Barcelona 08003, Spain; Cardiovascular Epidemiology and Genetics Research Group, Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona 08003, Spain
| | - Peter Kraft
- Department of Epidemiology, Harvard School of Public Health, Boston, MA 02115, USA
| | - Alison M Ayres
- The J. Philip Kistler Stroke Research Center, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Kristin Schwab
- The J. Philip Kistler Stroke Research Center, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Jacob L McCauley
- John P. Hussman Institute for Human Genomics, University of Miami, Miller School of Medicine, Miami, FL 33136, USA
| | - Joanna Pera
- Department of Neurology, Jagiellonian University Medical College, Krakow 31-008, Poland
| | - Andrzej Urbanik
- Department of Radiology, Jagiellonian University Medical College, Krakow 31-008, Poland
| | - Natalia S Rost
- Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA 02114, USA; Division of Neurocritical Care and Emergency Neurology, Department of Neurology, Massachusetts General Hospital, Boston, MA 02114, USA; The J. Philip Kistler Stroke Research Center, Massachusetts General Hospital, Boston, MA 02114, USA; Program in Medical and Population Genetics, Broad Institute, Cambridge, MA 02141, USA
| | - Joshua N Goldstein
- Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Anand Viswanathan
- The J. Philip Kistler Stroke Research Center, Massachusetts General Hospital, Boston, MA 02114, USA
| | | | - David L Tirschwell
- Stroke Center, Harborview Medical Center, University of Washington, Seattle, WA 98104, USA
| | - Magdy Selim
- Department of Neurology, Stroke Division, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA
| | - Devin L Brown
- Stroke Program, Department of Neurology, University of Michigan Health System, Ann Arbor, MI 48109, USA
| | - Scott L Silliman
- Department of Neurology, University of Florida College of Medicine, Jacksonville, FL 32209, USA
| | - Bradford B Worrall
- Department of Neurology and Public Health Sciences, University of Virginia Health System, Charlottesville, VA 22908, USA
| | - James F Meschia
- Department of Neurology, Mayo Clinic, Jacksonville, FL 32224, USA
| | - Chelsea S Kidwell
- Department of Neurology, University of Arizona, Tucson, AZ 85724, USA
| | - Joan Montaner
- Neurovascular Research Laboratory and Neurovascular Unit, Institut de Recerca, Hospital Vall d'Hebron, Universitat Autonoma de Barcelona, Barcelona 08035, Spain
| | - Israel Fernandez-Cadenas
- Neurovascular Research Laboratory and Neurovascular Unit, Institut de Recerca, Hospital Vall d'Hebron, Universitat Autonoma de Barcelona, Barcelona 08035, Spain; Stroke Pharmacogenomics and Genetics, Fundació Docència i Recerca Mútuaterrassa, Barcelona 08010, Spain
| | - Pilar Delgado
- Neurovascular Research Laboratory and Neurovascular Unit, Institut de Recerca, Hospital Vall d'Hebron, Universitat Autonoma de Barcelona, Barcelona 08035, Spain
| | - Rainer Malik
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-University, Munich 80539, Germany; Munich Cluster for Systems Neurology (Synergy), Munich 80539, Germany
| | - Martin Dichgans
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-University, Munich 80539, Germany; Munich Cluster for Systems Neurology (Synergy), Munich 80539, Germany
| | - Steven M Greenberg
- The J. Philip Kistler Stroke Research Center, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Peter M Rothwell
- Stroke Prevention Research Unit, Nuffield Department of Clinical Neuroscience, University of Oxford, Oxford OX3 9DU, UK
| | - Arne Lindgren
- Department of Clinical Sciences Lund, Neurology, Lund University, Lund 221 85, Sweden; Department of Neurology, Skåne University Hospital, Lund 221 85, Sweden
| | - Agnieszka Slowik
- Department of Neurology, Jagiellonian University Medical College, Krakow 31-008, Poland
| | - Reinhold Schmidt
- Department of Neurology, Medical University of Graz, Graz 8036, Austria
| | - Carl D Langefeld
- Center for Public Health Genomics and Department of Biostatistical Sciences, Wake Forest University, Winston-Salem, NC 27157, USA
| | - Jonathan Rosand
- Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA 02114, USA; Division of Neurocritical Care and Emergency Neurology, Department of Neurology, Massachusetts General Hospital, Boston, MA 02114, USA; The J. Philip Kistler Stroke Research Center, Massachusetts General Hospital, Boston, MA 02114, USA; Program in Medical and Population Genetics, Broad Institute, Cambridge, MA 02141, USA.
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