Sie befinden Sich nicht im Netzwerk der Universität Paderborn. Der Zugriff auf elektronische Ressourcen ist gegebenenfalls nur via VPN oder Shibboleth (DFN-AAI) möglich. mehr Informationen...
Apolipoprotein epsilon 4 genotype is associated with less improvement in cognitive function five years after cardiac surgery: a retrospective cohort study
Ist Teil von
Canadian journal of anesthesia, 2015-06, Vol.62 (6), p.618-626
Ort / Verlag
New York: Springer US
Erscheinungsjahr
2015
Link zum Volltext
Quelle
SpringerLink (Online service)
Beschreibungen/Notizen
Purpose
Cognitive performance after cardiac surgery can be impaired, and genetic risk factors have previously been suggested. When compared with other isoforms of the gene, the apolipoprotein
epsilon
4 (
APOE4
) allele is associated with worse outcomes in many neurologic disorders. We hypothesized that the
APOE4
allele is associated with less favourable cognitive function five years after surgery.
Methods
Caucasian patients enrolled in previously reported prospective cognitive trials in both cardiac and non-cardiac surgery participated in this retrospective cohort study. Neuropsychological function was assessed at baseline and five years postoperatively. The relationship between change in cognitive index score and
APOE
was evaluated using multivariable linear regression. An additive genetic model toward the
epsilon
4 allele was applied with adjustment for baseline cognition, years of education, age, presence of diabetes in both cohorts, and presence of coronary artery disease in the non-cardiac surgery cohort.
Results
A total of 357 patients were included in this study. In the cardiac surgery group (
n
= 233), baseline cognitive index (
P
< 0.001), years of education (
P
= 0.04), age at time of surgery (
P
< 0.001), and the
APOE4
allele (
P
= 0.009), were associated with a five-year change in cognitive index. Patients carrying the
APOE4
allele showed less improvement in cognitive index scores five years after cardiac surgery compared with patients without the
APOE4
allele. In the non-cardiac surgery (
n
= 124) group, no association was found between
APOE4
allele status and change in cognitive index.
Conclusion
We report an association between
APOE4
and neurocognitive function five years following cardiac surgery. Preoperative identification of patients with the
APOE4
genotype may improve stratification of cardiac surgery patients at risk for a less favourable cognitive trajectory.