Risk Factors Associated with Cerebral Amyloid Angiopathy Lobar Hemorrhage: A Single Center Cohort Analysis (P6.056)

Background: Older age, superficial siderosis and genetic predilection (ApoE) are risk factors for cerebral amyloid intracerebral hemorrhage (CAA-ICH). Additional risk factors for CAA-ICH and comparative studies to non-CAA-ICH have not been readily described. In this study, a comprehensive set of risk factors for CAA-ICH compared to non-CAA-ICH was evaluated. Methods: Prospectively collected ICH data was evaluated for 400 patients between 2009-2015. Medical history, demographics, ICH severity (ICH score, admission Glasgow Coma Score, hemorrhage volume), hemorrhage etiology, complications and discharge outcomes were collected. CAA-ICH was identified using the Boston Criteria. Logistic regression determined risk factors associated with CAA-ICH. Results: 44 CAA-ICH were identified from 400 total ICH admissions (11[percnt]). Patients with CAA-ICH (80.2+/-7.2 years) were significantly older than non-CAA-ICH patients (60.19+/-17.19 years). Multivariable logistic regression revealed that older age (OR: 1.1 per year, 95[percnt] CI: 1-1.1, P<0.001), female sex (OR: 5.5, 95[percnt] CI: 2.4-12.6, P<0.001), prior ICH (OR: 7.7, 95[percnt] CI: 2.5-25, P<0.001), and history of cancer (OR: 3.46, 95[percnt] CI: 1.25-11, P=0.02) were significantly associated with CAA-ICH. There was a non-significant association between dyslipidemia and CAA-ICH (OR: 2.05, 95[percnt] CI: 0.94-4.45, P=0.067). Furthermore, CAA-ICH patients were less likely to be dead at discharge (OR: 0.149, 95[percnt] CI: 0.04-0.49, P<0.01) and had trends towards less surgical inteventions compared to non-CAA-ICH (univariate analysis for extraventricular drain placement: OR: 0.11, 95[percnt] CI: 0.02-0.47, P<0.01; surgical evacuation: OR: 0.3, 95[percnt] CI: 0.07-1.3, P=0.11). Conclusions: This cohort analysis is congruent with prior CAA-ICH studies revealing increased incidence with age, dementia and prior bleeding. However, female gender, dyslipidemia, and cancer have not previously been associated with CAA-ICH and may reflect a particular CAA patient phenotype at risk for ICH. Furthermore, CAA-ICH appears to pose less risk for death and may pose less risk for surgical intervention. However, given the small sample size, further investigation is warranted. Disclosure: Dr. Roh has nothing to disclose. Dr. Schmidt has nothing to disclose. Dr. Roth has nothing to disclose. Dr. Honig has received personal compensation for activities with Johnson & Johnson/Janssen and Eli Lilly as a consultant and/or a scientific advisory board member. Dr. Merkler has nothing to disclose. Dr. Park has nothing to disclose. Dr. Connolly has nothing to disclose. Dr. Kamel has received personal compensation from Genentech as a speaker. Dr. Kamel has received personal compensation in an editorial capacity for Journal Watch Neurology. Dr. Claassen has received personal compensation for activities with the JSMF Foundation, Actelion, and SAGE Pharmaceutical.