Abstract 42: Haptoglobin 2-2 Phenotype Is associated with Cerebral Salt Wasting Syndrome in Aneurysmal Subarachnoid Hemorrhage
INTRODUCTION: The Haptoglobin (Hp) phenotype has been shown to be a predictor of clinical outcomes in cerebrovascular disorders. We sought to determine if the Hp phenotype was predictive of cerebral salt wasting (CSW) following aneurysmal subarachnoid hemorrhage (SAH).
METHODS: Patients admitted with a diagnosis of SAH were divided into three groups based on their genetically determined Hp phenotype: 1-1, 2-1, and 2-2. Outcome measures included CSW, delayed cerebral infarction (DCI) and favorable outcome -Glasgow Outcome score (GOS) of 4-5 at 30 days. CSW was diagnosed by a clinician, and met the following criteria: hyponatremia 4 liters in 12 hours with urine sodium > 40 mEq/L. Pearson’s Chi Square and Wilcoxon-Mann-Whitney tests were used for categorical and continuous variables respectively. Logistic regression was used to assess association between Hp phenotype and SAH outcomes.
RESULTS: A total of 133 patients were included in the study. The distribution of Hp phenotype was- Hp 1-1: 29 (21.8%), Hp 2-1: 57 (42.9%), Hp 2-2: 47 (35.3%). The three Hp subgroups did not differ in terms of demographic variables, comorbidities or SAH characteristics. CSW occurred in 1 patient (3.4%) with Hp 1-1, 8 (14.0%) with Hp 2-1 and 15 (31.9%) with Hp 2-2 (p=0.004). In the multivariate analysis adjusted for age, sex, race, Hunt-Hess score and hydrocephalus, Hp 2-2 was associated with CSW (OR: 4.94 CI: 1.78-17.43, p=0.013) but Hp 2-1 was not (OR: 2.92, CI: 0.56-4.95, p=0.150). There were no associations between Hp phenotypes and favorable outcomes or DCI. CSW correlated strongly with development of DCI (OR: 7.16, OR: 2.48-20.62, p<0.001).
CONCLUSIONS: Hp 2-2 phenotype was an independent predictor of cerebral salt wasting following SAH. There were no associations between Hp phenotype and DCI or good functional outcome.
Author Disclosures: S.B. Murthy: None. J. Caplan: None. S. Hadar: None. W.C. Ziai: None. A.P. Levy: None. R.J. Tamargo: None. P.A. Nyquist: None.
- © 2015 by American Heart Association, Inc.