AUTHOR=Han Sung Woo , Kim Bong Jun , Kim Tae Yeon , Lim Seung Hyuk , Youn Dong Hyuk , Hong Eun Pyo , Rhim Jong Kook , Park Jeong Jin , Lee Jae Jun , Cho Yong Jun , Gaastra Ben , Galea Ian , Jeon Jin Pyeong 

TITLE=Association of Haptoglobin Phenotype With Neurological and Cognitive Outcomes in Patients With Subarachnoid Hemorrhage

JOURNAL=Frontiers in Aging Neuroscience

VOLUME=14

YEAR=2022

URL=https://www.frontiersin.org/journals/aging-neuroscience/articles/10.3389/fnagi.2022.819628

DOI=10.3389/fnagi.2022.819628

ISSN=1663-4365

ABSTRACT=<sec><title>Background</title><p>To assess the association of haptoglobin (Hp) phenotype with neurological and cognitive outcomes in a large cohort of patients with subarachnoid hemorrhage (SAH).</p></sec><sec><title>Methods</title><p>This prospective multicenter study enrolled patients with aneurysmal SAH between May 2015 and September 2020. The Hp phenotype was confirmed <italic>via</italic> Western blots. The relative intensities of α1 in individuals carrying Hp2-1 were compared with those of albumin. Multivariable logistic and Cox proportional-hazard regression analyses were used to identify the risk factors for 6-month and long-term outcomes, respectively.</p></sec><sec><title>Results</title><p>A total of 336 patients including the phenotypes Hp1-1 (<italic>n</italic> = 31, 9.2%), Hp2-1 (<italic>n</italic> = 126, 37.5%), and Hp2-2 (<italic>n</italic> = 179, 53.3%) were analyzed. The Hp phenotype was closely associated with 6-month outcome (<italic>p</italic> = 0.001) and cognitive function (<italic>p</italic> = 0.013), and long-term outcome (<italic>p</italic> = 0.002) and cognitive function (<italic>p</italic> &lt; 0.001). Compared with Hp1-1 as the reference value, Hp2-2 significantly increased the risk of 6-month poor outcome (OR: 7.868, 95% CI: 1.764–35.093) and cognitive impairment (OR: 8.056, 95% CI: 1.020–63.616), and long-term poor outcome (HR: 5.802, 95% CI: 1.795–18.754) and cognitive impairment (HR: 7.434, 95% CI: 2.264–24.409). Long-term cognitive impairment based on the Hp phenotype was significantly higher in patients under 65 years of age (<italic>p</italic> &lt; 0.001) and female gender (<italic>p</italic> &lt; 0.001). A lower relative α1/albumin intensity (OR: 0.010, 95% CI: 0.000–0.522) was associated with poor outcome at 6 months but not cognitive impairment in patients with SAH expressing Hp2-1.</p></sec><sec><title>Conclusion</title><p>Hp2-2 increased the risk of poor neurological outcomes and cognitive impairment compared with Hp1-1. For Hp2-1, higher relative α1 intensities were related to 6-month favorable outcomes.</p></sec>