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A Mouse Model of Orthopedic Surgery to Study Postoperative Cognitive Dysfunction and Tissue Regeneration

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Published on: February 27, 2018

Genetic variation and cognitive dysfunction one year after cardiac surgery.

A Stewart¹, R Katznelson, N Kraeva

¹University of Toronto, Toronto, Canada.

|February 7, 2013

Summary

Genetic variants in platelet glycoprotein-IIIa (Pl(A2) allele) are associated with long-term postoperative cognitive dysfunction after cardiac surgery. Apolipoprotein E-ε4 showed no significant association. Further validation is needed.

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Area of Science:

Cardiovascular Surgery
Neuroscience
Genetics

Background:

Postoperative cognitive dysfunction (POCD) is a concern after cardiac surgery.
Candidate gene polymorphisms are potential risk factors for POCD, but evidence is limited.
Platelet glycoprotein-IIIa and apolipoprotein-E are implicated in cognitive function.

Purpose of the Study:

To investigate the association between specific gene variants and POCD one year after cardiac surgery.
To examine the role of platelet glycoprotein-IIIa (Pl(A2) allele) and apolipoprotein E-ε4 (APOE ε4) in long-term POCD.
To determine if combined alleles influence POCD risk.

Main Methods:

A cohort of 155 patients undergoing cardiac surgery was studied.
Neuropsychological testing was performed at one-year follow-up to assess cognitive function.
Genotyping for Pl(A2) allele and APOE ε4 was conducted.

Main Results:

Cognitive dysfunction was observed in 20% of patients at one year.
The Pl(A2) allele was significantly more prevalent in patients with POCD (42% vs. 20%, p=0.012).
The combined presence of Pl(A2) and APOE ε4 alleles was also significantly associated with POCD (19% vs. 4%, p=0.003).

Conclusions:

The Pl(A2) allele of the platelet glycoprotein-IIIa gene may be a risk factor for developing long-term POCD after cardiac surgery.
APOE ε4 alone did not show a significant association, but its combination with Pl(A2) increased risk.
Further research, including age-adjusted non-surgical controls, is necessary to validate these genetic associations.