Association of promoter polymorphism of apolipoprotein E gene with cerebral vasospasm after spontaneous SAH.

Cerebral vasospasm (CV) is the main complication of spontaneous subarachnoid hemorrhage (SAH), affecting clinical outcome of patients with SAH. Accumulating evidence indicates that apolipoprotein E (apoE protein, APOE gene) gene polymorphism is associated with prognosis of patients with SAH. The current study aimed to investigate the association of promoter polymorphism of APOE with CV in patients with SAH. One hundred and one patients with spontaneous SAH were involved in this study. Venous blood samples were collected to identify the promoter genotype of APOE by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). CV was judged by transcranial Doppler sonography (TCD) combined with patients' condition. Associations of APOE promoter polymorphism with CV after SAH were analyzed by χ(2) test, uni- and multivariate logistic regression analyses. In 101 patients, 42 of 87 patients (48.3%) with promoter -219T allele showed CV, which was significantly different from those with -219G allele (23/61, 37.7%, P=0.04). Uni- and multivariate logistic regression analyses also showed that promoter -219T was a risk factor to predispose CV after SAH. However, there was no significant association between promoter -491A/T (rs#449647) or -427C/T (rs#769446) polymorphisms and SAH induced CV (P>0.05). Our finding suggests that patients with APOE -219T promoter are apt to CV after spontaneous SAH.