医学
围手术期
血小板活化
内科学
等位基因
心肌梗塞
血小板
胃肠病学
基因型
杂合子优势
不利影响
麻醉
基因
生物
遗传学
作者
Ewa Stępień,Sylwia Krawczyk,Bogusław Kapelak,Robert Sobczyński,Jarosław Stoliński,Ewa Wypasek,Anetta Undas,Jerzy Sadowski
标识
DOI:10.1016/j.arcmed.2011.07.007
摘要
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.
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