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Inflammatory system genes linked to cognitive decline after heart surgery

DURHAM, N.C. -- Variants of two genes involved in the inflammatory system appear to protect patients from suffering a decline in mental function following heart surgery.

Duke University Medical Center researchers believe their findings could help physicians identify patients at risk of suffering mental decline after heart surgery and raises the possibility that these patients could be treated with drugs that are known to dampen the inflammatory response.

Six years ago, the Duke researchers demonstrated that 42 percent of patients who underwent coronary artery bypass surgery had measurable cognitive decline five years after their procedure. Since that finding, the team has been investigating possible reasons for this decline.

The researchers selected known variations in 37 genes that previous studies had implicated in various impairments of cognitive and mental function. When they looked at more than 500 heart surgery patients and correlated cognitive decline with the patients genetic makeup, they discovered that patients with two specific variants were less likely to have problems with areas of cognitive function such as memory, attention and concentration.

While bypass surgery has saved millions of Americans with coronary artery disease, many patients and families find that cognitive decline after surgery has reduced their quality of life, said Duke cardiothoracic anesthesiologist Joseph Mathew, M.D., lead investigator of the study reported online Tuesday, May 1, in the Journal of the American College of Cardiology. The study was supported by the National Institutes of Health and the American Heart Association.

The two gene variants we found were involved in some manner with the inflammatory system, raising the possibility that therapies given during surgery aimed at the controlling the inflammatory response would be protective, Mathew said. Also, our results provide additional evidence for a genetic basis for th
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Contact: Richard Merritt
Merri006@mc.duke.edu
919-684-4148
Duke University Medical Center
1-May-2007


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