Effect of the E-selectin gene polymorphism (S149R) on platelet activation and adverse events after coronary artery surgery

A common single nucleotide polymorphism in the E-selectin (SELE) gene S149R results in the loss of E-selectin ligand binding specificity. The 149R allele has been associated with severe cardiovascular diseases. We hypothesized that S149R may regulate platelet activation after stimuli associated with perioperative procedures in patients undergoing isolated coronary artery bypass grafting (CABG). Associations between the S149R polymorphism and an increased risk of perioperative acute thrombotic events with regards to a platelet count and activity were analyzed.

In elective CABG patients (n = 152) we analyzed associations between S149R polymorphism and an increased risk of perioperative acute thrombotic events with regard to platelet count and activity. The S149R SELE gene polymorphism was determined by real-time polymerase chain reaction. Platelet count and activation marker (β-thromboglobulin-βTG) were evaluated.

Prevalence of the S149R genotypes was as follows: 81.8% (n = 121) of homozygotes (149SS), 15.5% (n = 23) of heterozygotes and 2.7% (n = 4) of homozygotes (149RR). The 149R allele carriers had significantly higher postoperative βTG levels than the homozygotes (97 [79-120] vs. 76 [66-91] IU/mL, p = 0.03). Sixteen patients had adverse events: myocardial infarction (n = 14), stroke (n = 1) and fatal pulmonary embolism (n = 1). Twelve patients were carriers of the 149R allele. Relative risk (RR) of postoperative adverse events in the 149R allele carriers was 2.03 with 95% CI (1.05-3.03).

Postoperative platelet activation is related to the S149R polymorphism, which enhances the risk of adverse events after CABG.