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Article Type

Original Study

Abstract

Background Aneurysmal subarach noid hemorrhage (aSAH) represents roughly 6–8% of all stroke types. Almost 70% of patients develop angiographic vasospasm, and 30% of them will have delayed cerebral ischemia (DCI). An 'omic signature' could combine genetic, proteomic, and metabolomic phenotypes into an accurate predictive model. Haptoglobin (Hp) genotypes could be used to stratify risk of resulting cerebral vasospasm (CV) and DCI, to give prognostic data dependent on distributed result probabilities, and to develop novel medications dependent on individual pathophysiological models. Objective This research intends to investigate the clinical and radiological factors as indicators for risk of development of CV after aSAH in Egyptian population, with the review of Hp genotype role as a predictor for CV. Patients and methods A total of 50 patients with aSAH were enrolled and followed up clinically and radiologically by transcranial Doppler examination for 14 days following presentation to early recognize hemodynamic changes related with CV and additional events of DCI as a result of CV. In this investigation, we attempted to analyze clinical data to find the potential hazard factors that are prescient of CV and DCI during the acute phase of aSAH. Results Approximately 34 (68%) patients developed CV; among them, 19 (38%) patients had DCI. History of hypertension [relative risk (RR)=1.6], diabetes mellitus (RR=1.5), and smoking (RR=1.5) had a significant independent relationship (P<0.05) with short-term hazard to develop CV following aSAH. However, age, sex, dyslipidemia, cardiovascular disease, and peripheral vascular disease did not show any relationship. Regarding poor Fisher scale and poor Hunt and Hess score, both demonstrated significant relationship with CV (P<0.05). Conclusion Hypertension, diabetes, smoking, poor Fisher grade, and poor Hunt and Hess scale are independent risk factors for CV. The Hp genotype may be used as a predictor for risk for development of CV after aSAH. This has the potential for use in risk stratification.

Keywords

Haptoglobin, subarachnoid hemorrhage, vasospasm

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