C-Reactive protein gene variants are associated with postoperative C-reactive protein levels after coronary artery bypass surgery.
BACKGROUND
Elevated baseline C-reactive protein (CRP) levels are associated with increased risk for developing cardiovascular disease. Several CRP gene variants have been associated with altered baseline CRP levels in ambulatory populations. However, the influence of CRP gene variants on CRP levels during inflammatory states, such as surgery, is largely unexplored. We describe the association between candidate CRP gene variants and postoperative plasma CRP levels in patients undergoing primary, elective coronary artery bypass graft (CABG) surgery with cardiopulmonary bypass (CPB).


METHODS
Using a multicenter candidate gene association study design, we examined the association between seventeen candidate CRP single nucleotide polymorphisms (SNPs) and inferred haplotypes, and altered postoperative CRP levels in 604 patients undergoing CABG surgery with CPB. Perioperative CRP levels were measured immediately prior to surgery, post-CPB and on postoperative days (POD) 1-4.


RESULTS
CRP levels were significantly elevated at all postoperative time points when compared with preoperative levels (P < 0.0001). After adjusting for clinical covariates, the minor allele of the synonymous coding SNP, rs1800947 was associated with lower peak postoperative CRP levels (P = 2.4 x 10(-4)) and lower CRP levels across all postoperative time points (P = 4.8 x 10(-5)). rs1800947 remained highly significant after Bonferroni adjustment for multiple comparisons.


CONCLUSIONS
We identified a CRP gene SNP associated with lower postoperative CRP levels in patients undergoing CABG surgery with CPB. Further investigation is needed to clarify the significance of this association between CRP gene variants and the acute-phase rise in postoperative CRP levels with regard to the risk of adverse postoperative outcomes.
Perry
Tjörvi E
TE
Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. tjorviperry@gmail.com
Muehlschlegel
Jochen D
JD
Liu
Kuang-Yu
KY
Fox
Amanda A
AA
Collard
Charles D
CD
Body
Simon C
SC
Shernan
Stanton K
SK
D000210:Acute-Phase Reaction / Q000235:genetics; D000368:Aged; D002097:C-Reactive Protein / Q000235:genetics*; D002315:Cardiopulmonary Bypass; D015331:Cohort Studies; D001026:Coronary Artery Bypass; D005260:Female; D055106:Genome-Wide Association Study; D005838:Genotype; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D020641:Polymorphism, Single Nucleotide; D011184:Postoperative Period; D012307:Risk Factors
D002097:C-Reactive Protein