HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Marko Turina Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Drabe, N. Articles by Turina, M. Search for Related Content PubMed PubMed Citation Articles by Drabe, N. Articles by Turina, M. Related Collections Cardiac - pharmacology Extracorporeal circulation

Eur J Cardiothorac Surg 2001;20:609-613
© 2001 Elsevier Science NL

Genetic predisposition in patients undergoing cardiopulmonary bypass surgery is associated with an increase of inflammatory cytokines

^a Clinic for Cardiovascular Surgery, University Hospital Zürich, Zürich, Switzerland
^b Institute of Clinical Chemistry, University Hospital Zürich, Zürich, Switzerland
^c Division of Surgical Research, University Hospital Zürich, Zürich, Switzerland

Received 5 December 2000; received in revised form 31 May 2001; accepted 31 May 2001.

Corresponding author. Tel.: +41-1-2553801; fax: +41-1-2554369
e-mail: gregor.zund{at}chi.usz.ch

Objective: Cardiopulmonary bypass (CPB) surgery induces a transient rise in pro-inflammatory cytokines typically released by activated monocytes. The E4 variant of apolipoprotein E is a recognized risk factor for atherosclerosis. It has recently been shown that apolipoprotein E affects monocyte functions in vitro and leads to higher levels of median lipoprotein (a) in humans. The aim of the study is to investigate if the E4 genetic variant of apolipoprotein E affects cytokine release after CPB surgery. Methods: 22 patients were operated on with standard coronary artery bypass grafting. Concentrations of interleukin 8 (IL-8) and tumor necrosis factor (TNF-) were measured by automated Immulite immunoassay at regular intervals within 48 h after surgery. Total apparent cytokine outputs were calculated as area under the curve. Results are expressed as mean±standard deviation and compared by unpaired t-test. Results: In the presented patient population 6 (27%) carried the E4 allele. Sixteen (63%) showed no E4 allele. Mean cross clamp time (CCT) was 56.2±13.5 min versus 55.7±12.1 min and CPB time was 91.8±17.5 versus 93.5±15.7 min. No statistical difference between E4-carriers and E4 non-carriers regarding CCT and CPB was observed. The total amount of IL-8 and TNF- was higher in patients carrying the E4 genetic variant of apolipoprotein E in comparison to E4 non-carriers (P<0.08, P<0.039). Conclusion: The presence of the E4 allele is associated with increased release of IL-8 and TNF- after CBP surgery. The preoperative determination of E4 in patients undergoing cardiac surgery may lead to additional perioperative measures for the treatment of an increased systemic inflammatory response.

Key Words: Cardiac surgery • Ischemia/reperfusion • Adhesion molecules • Cytokines • Apolipoprotein E

This article has been cited by other articles:

				J. W. Hammon Extracorporeal Circulation: The Response of Humoral and Cellular Elements of Blood to Extracorporeal Circulation Card. Surg. Adult, January 1, 2008; 3(2008): 370 - 389. [Full Text]

				I. Massad, H. Abu-Ali, C. Biron-Andreani, M.-C. Picot, and P. trinh-Duc Antithrombin and Protein C in Systemic Inflammatory Response Syndrome Asian Cardiovasc Thorac Ann, February 1, 2007; 15(1): 39 - 44. [Abstract] [Full Text] [PDF]

				H. P. Grocott Genetic influences on cerebral outcome after cardiac surgery. Seminars in Cardiothoracic and Vascular Anesthesia, December 1, 2006; 10(4): 291 - 296. [Abstract] [PDF]

				C. E. Finch A perspective on sporadic inclusion-body myositis: The role of aging and inflammatory processes Neurology, January 24, 2006; 66(1_suppl_1): S1 - S6. [Abstract] [Full Text] [PDF]

				A. Anselmi, A. Abbate, F. Girola, G. Nasso, G. G.L. Biondi-Zoccai, G. Possati, and M. Gaudino Myocardial ischemia, stunning, inflammation, and apoptosis during cardiac surgery: a review of evidence Eur. J. Cardiothorac. Surg., March 1, 2004; 25(3): 304 - 311. [Abstract] [Full Text] [PDF]

				J. W. Gaynor, M. Gerdes, E. H. Zackai, J. Bernbaum, G. Wernovsky, R. R. Clancy, M. F. Newman, A. M. Saunders, P. J. Heagerty, J. A. D'Agostino, et al. Apolipoprotein E genotype and neurodevelopmental sequelae of infant cardiac surgery J. Thorac. Cardiovasc. Surg., December 1, 2003; 126(6): 1736 - 1745. [Abstract] [Full Text] [PDF]

				P. Menasche and L. H. Edmunds Jr. Extracorporeal Circulation: The Inflammatory Response Card. Surg. Adult, January 1, 2003; 2(2003): 349 - 360. [Full Text]