Why the study?
Does the presence of Pl(A2) and apolipoprotein-ε4 alleles increase postoperative cognitive dysfunction in patients undergoing cardiac surgery?
Does the presence of Pl(A2) and apolipoprotein-ε4 alleles increase postoperative cognitive dysfunction in patients undergoing cardiac surgery?
The presence of the Pl(A2)-allele of the platelet glycoprotein-IIIa gene, particularly in combination with the apolipoprotein-ε4 allele, is associated with an increased risk of cognitive dysfunction one year after cardiac surgery.
May refine perioperative cognitive risk stratification in cardiac surgery; hypothesis-generating and requires prospective validation before practice change.
Various studies have implicated a potential association between candidate gene polymorphisms and postoperative cognitive dysfunction, yet corroborative studies are lacking. We investigated the variants in genes encoding platelet glycoprotein-IIIa and apolipoprotein-E and their relationship with postoperative cognitive dysfunction one year after cardiac surgery. A total of 155 patients were studied; neuropsychological testing demonstrated cognitive dysfunction in 31 (20%) patients at one-year follow-up. No differences were detected with respect to baseline characteristics, pre-operative variables and surgical data between the patients with and without cognitive dysfunction. The Pl(A2) -allele of the platelet glycoprotein-IIIa gene was present in 13 (42%) and 25 (20%) patients with and without cognitive dysfunction, respectively, p = 0.012. The apolipoprotein E-ε4 allele was present in 9 (29%) and 24 (19%) patients with and without cognitive dysfunction, respectively, p = 0.24. Both the Pl(A2) and apolipoprotein-ε4 alleles were present together in 6 (19%) and 5 (4%) patients with and without cognitive dysfunction, respectively, p = 0.003. Validation of these findings is required in age-adjusted non-surgical controls.
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Stewart et al. (2013) studied this question.
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