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Inflammatory system genes linked to cognitive decline after heart surgery

e cognitive deterioration seen after heart surgery.

The researchers found that patients with variants in genes for C-reactive protein and P-selectin were less likely to suffer cognitive decline than were patients without the variants. C-reactive protein plays an important role in the bodys initial response to injury, and studies have shown that high levels of the protein put patients at higher risk for cardiovascular disease and stroke. P-selectin is a molecule that helps recruit circulating white blood cells to the site of an injury.

For their analysis, the researchers gave 513 heart patients at Duke University Hospital a battery of cognitive exams before heart surgery and then six weeks later. They found that patients with the variation of the C-reactive protein gene were 20.6 percent less likely to suffer mental decline, and patients with the P-selectin variant had a 15.2 percent risk reduction. The incidence of deficit in patients with both gene variants was 17 percent compared to 43 percent in patients who had neither variant.

Furthermore, patients with the two gene variants had significantly lower levels of C-reactive protein in their bloodstream and lower P-selectin expression, and the researchers said this factor may provide a biological basis for the protective effect they observed.

Although we have made significant progress in minimizing the adverse events related to cardiac surgery, little progress has been made in reducing postoperative cognitive decline, said Mark Newman, M.D., chairman of anesthesiology and senior member of the research team. While we know that there are many factors involved in this phenomenon, the results of this study provide insight into the genetic factors that influence cognition and may translate into more precise identification of at-risk patients.

Coronary artery bypass grafting surgery is performed more than 600,000 times a year in the United States for the treatment of corona
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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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