Apolipoprotein E4 genotype increases the risk of postoperative cognitive dysfunction in patients undergoing coronary artery bypass graft surgery

J Cardiovasc Surg (Torino). 2006 Aug;47(4):451-6.

Abstract

Aim: The aim of this study was to investigate the association between the presence of ApoE4 and the incidence of postoperative cognitive dysfunction (POCD) after cardiac surgery.

Methods: Eighty-seven adult patients undergoing elective coronary artery bypass graft surgery were observed prospectively at a university tertiary care hospital. All patients were evaluated with the Mini-Mental State Examination (MMSE) and the Glasgow Coma Scale (GCS) for cognitive function and mental status preoperatively, 24 h after surgery and at postoperative day 6. Patients were genotyped for the ApoE polymorphism. The association between ApoE genotype and MMSE evolution was studied by using repeated measures ANOVA.

Results: Both the presence of at least one ApoE4 allele and POCD were verified in 21.8% of subjects. The presence of the ApoE4 allele was significantly associated with a worse MMSE score evolution (P=0.04).

Conclusion: This study suggests an association between ApoE4 and early POCD, but further studies are needed to clarify a causative association. Such new studies should include a more homogenous patient sample and a longer follow-up.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Alleles
  • Apolipoprotein E4
  • Apolipoproteins E / blood
  • Apolipoproteins E / genetics*
  • Cognition Disorders / blood*
  • Cognition Disorders / etiology
  • Cognition Disorders / genetics
  • Coronary Artery Bypass / adverse effects*
  • Coronary Disease / blood
  • Coronary Disease / surgery*
  • DNA / genetics*
  • Female
  • Follow-Up Studies
  • Genotype
  • Humans
  • Male
  • Middle Aged
  • Postoperative Complications
  • Prognosis
  • Risk Factors

Substances

  • Apolipoprotein E4
  • Apolipoproteins E
  • DNA