Genetic Variants in P-Selectin and C-Reactive Protein Influence Susceptibility to Cognitive Decline After Cardiac Surgery
Joseph P. Mathew, MD*,*,
Mihai V. Podgoreanu, MD*,
Hilary P. Grocott, MD*,
William D. White, MPH*,
Richard W. Morris, PhD*,
Mark Stafford-Smith, MD*,
G. Burkhard Mackensen, MD*,
Christine S. Rinder, MD||,
James A. Blumenthal, PhD ,
Debra A. Schwinn, MD*, , ,
Mark F. Newman, MD* for the PEGASUS Investigative Team
* Anesthesiology
Psychiatry
Pharmacology/Cancer Biology
Duke Institute for Genome Sciences and Policy, Duke University Medical Center, Durham, North Carolina
|| Departments of Anesthesiology and Laboratory Medicine, Yale University School of Medicine, New Haven, Connecticut.
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Figure 1 Incidence of Postoperative Cognitive Deficit by CRP 1059G/C and SELP 1087G/A Genotypes
The incidence of cognitive deficit was 16.7% in carriers of minor alleles at both of these loci compared with 42.9% in patients homozygous for the major allele. CRP = C-reactive protein; SELP = P-selectin. n = 386.
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Figure 2 Median CRP Levels by CRP 1059G/C Genotypes
C-reactive protein (CRP) levels at the 24-h sampling time in patients homozygous (C/C) or heterozygous (C/G) for the minor allele were lower compared with patients homozygous (G/G) for the major allele. n = 225. *p < 0.05.
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Figure 3 Median Platelet Activation (Relative to Baseline) by SELP 1087G/A Genotypes
Platelet activation was significantly lower upon release of the cross-clamp in patients with the homozygous minor (A/A) or heterozygous (G/A) genotype compared with patients homozygous (G/G) for the major allele. CPB = cardiopulmonary bypass; SELP = P-selectin. n = 93. *p < 0.05.
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