The +405 GG variant of vascular endothelial growth factor polymorphism is associated with poor prognosis in patients undergoing coronary artery bypass graft surgery.
BACKGROUND
Coronary artery bypass graft (CABG) surgery is associated with systemic response and increased concentrations of numerous cytokines. Vascular endothelial growth factor (VEGF) related pathway also seems to be involved in inflammatory response induced by CABG.


OBJECTIVE
The aim of this study was to analyze the association between the VEGF gene +405 G>C polymorphism (linked to serum VEGF production), and the short-term clinical outcome during the in-hospital period (30 days) in patients undergoing CABG.


METHODS
Genotyping for VEGF gene +405 G>C polymorphism was performed in 64 patients with coronary artery disease at a mean age of 66 years (76.6% males), with a mean EuroSCORE (European System for Cardiac Operative Risk Evaluation) of 2.5 (0-2 points: 50% patients, 3-4: 25%, > or =5 points: 25%), who underwent CABG surgery.


RESULTS
Twenty-one (33%) patients were homozygous for the +405 G allele, 40 (63%) were heterozygous, and 3 were homozygous for the +405 C allele. Ten patients died during the 30-day follow-up (7 subjects with +405 GG genotype, and the other 3 carriers of the +405 C allele). Using multivariate logistic regression analysis, the risk of death after CABG was increased in patients with +405 GG genotype (odds ratio [OR] = 6.7; 95% confidence interval [CI] 1.5-29.4) and with EuroSCORE > or =5 points (OR = 4.4; 95% CI 1.1-18.1).


CONCLUSIONS
The VEGF gene +405 G>C polymorphism might be a prognostic factor of an adverse postoperative course in patients undergoing CABG surgery. Apart from its proangiogenic action, VEGF may have additional, possibly proinflammatory properties.
Pastuszczak
Maciej
M
Joseph Dietl Hospital, Kraków, Poland. mpastuszczak@wp.pl
Branicka
Agnieszka
A
Jakiela
Bogdan
B
Stepień
Ewa
E
Jaworek
Andrzej K
AK
Wojas-Pelc
Anna
A
Kapelak
Bogusław
B
Sadowski
Jerzy
J
D000328:Adult; D000368:Aged; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000235:genetics* / Q000401:mortality / Q000601:surgery; D023903:Coronary Restenosis / Q000235:genetics* / Q000401:mortality; D005260:Female; D005787:Gene Frequency; D005838:Genotype; D006801:Humans; D008297:Male; D008875:Middle Aged; D011110:Polymorphism, Genetic; D011379:Prognosis; D018570:Risk Assessment; D042461:Vascular Endothelial Growth Factor A / Q000235:genetics*
D042461:Vascular Endothelial Growth Factor A