Presence of lipoprotein lipase S447X stop codon affects the magnitude of interleukin 8 release after cardiac surgery with cardiopulmonary bypass.
OBJECTIVE
Current data suggest that individual genetic predisposition may influence the magnitude of cytokine response and the degree of organ dysfunction after cardiopulmonary bypass. Lipoprotein lipase S447X polymorphism has been shown to be protective against atherosclerosis. The aim of the study was to investigate the effect of lipoprotein lipase S447X polymorphism on cytokine release and early outcome after cardiopulmonary bypass.


METHODS
Forty patients who underwent coronary artery bypass grafting with cardiopulmonary bypass were included. Genotyping for lipoprotein lipase S447X polymorphism was performed by polymerase chain reaction. Levels of interleukins 6 and 8 were measured before induction and 6, 24, and 72 hours after operation by enzyme-linked immunosorbent assay. Clinical data were collected prospectively. Daily assessment of organ dysfunction was done according to the cardiac surgery scoring (CASUS) system.


RESULTS
The allele frequency of lipoprotein lipase S447X stop codon was 17.5%. S447X carriers revealed significantly lower interleukin 8 levels at the sixth and 24th postoperative hours than the noncarrier group (P = .005 and P = .041, respectively). Patients in the S447X carrier group had significantly shorter ventilation times than the noncarrier group (P = .048). Also, the S447X carrier group revealed significantly lower postoperative 6-hour lactate levels, operative day, and postoperative day 1 organ dysfunction scores than the other group (P = .001, .005 and .002, respectively).


CONCLUSIONS
Lipoprotein lipase S447X stop codon mutation is associated with lower levels of interleukin 8 after coronary artery bypass grafting. Identification of high-risk patients for cardiopulmonary bypass-related systemic inflammation by detecting lipoprotein lipase S447X stop codon polymorphism may improve early postoperative outcome, especially in patients with limited organ reserves.
Marmara University School of Medicine, Department of Cardiovascular Surgery, Istanbul, Turkey. akkoray@hotmail.com
Koray
K
Ak
Selim
S
Isbir
Atike
A
Tekeli
Arzu
A
Ergen
Nazan
N
Atalan
Selami
S
Dogan
Ali
A
Civelek
Sinan
S
Arsan
D015415:Biomarkers / Q000097:blood; D002315:Cardiopulmonary Bypass; D002353:Carrier State; D016009:Chi-Square Distribution; D018388:Codon, Terminator; D001026:Coronary Artery Bypass; D005787:Gene Frequency; D020022:Genetic Predisposition to Disease; D005838:Genotype; D006801:Humans; D015850:Interleukin-6 / Q000097:blood / Q000235:genetics; D016209:Interleukin-8 / Q000097:blood / Q000235:genetics*; D008071:Lipoprotein Lipase / Q000235:genetics*; D016133:Polymerase Chain Reaction; D011110:Polymorphism, Genetic; D011446:Prospective Studies; D012044:Regression Analysis; D012720:Severity of Illness Index
D015415:Biomarkers; D018388:Codon, Terminator; D015850:Interleukin-6; D016209:Interleukin-8; D008071:Lipoprotein Lipase