title: Thrombotic gene polymorphisms and postoperative outcome after coronary artery bypass graft surgery.
abstract: BACKGROUND
  Emerging perioperative genomics may influence the direction of risk assessment and surgical strategies in cardiac surgery. The aim of this study was to investigate whether single nucleotide polymorphisms (SNP) affect the clinical presentation and predispose to increased risk for postoperative adverse events in patients undergoing coronary artery bypass grafting surgery (CABG).
  
  
  METHODS
  A total of 220 patients undergoing first-time CABG between January 2005 and May 2008 were screened for factor V gene G1691A (FVL), prothrombin/factor II G20210A (PT G20210A), angiotensin I-converting enzyme insertion/deletion (ACE-ins/del) polymorphisms by PCR and Real Time PCR. End points were defined as death, myocardial infarction, stroke, postoperative bleeding, respiratory and renal insufficiency and event-free survival. Patients were compared to assess for any independent association between genotypes for thrombosis and postoperative phenotypes.
  
  
  RESULTS
  Among 220 patients, the prevalence of the heterozygous FVL mutation was 10.9% (n = 24), and 3.6% (n = 8) were heterozygous carriers of the PT G20210A mutation. Genotype distribution of ACE-ins/del was 16.6%, 51.9%, and 31.5% in genotypes I/I, I/D, and D/D, respectively. FVL and PT G20210A mutations were associated with higher prevalence of totally occluded coronary arteries (p < 0.001). Furthermore the risk of left ventricular aneurysm formation was significantly higher in FVL heterozygote group compared to FVL G1691G (p = 0.002). ACE D/D genotype was associated with hypertension (p = 0.004), peripheral vascular disease (p = 0.006), and previous myocardial infarction (p = 0.007).
  
  
  CONCLUSIONS
  FVL and PT G20210A genotypes had a higher prevalence of totally occluded vessels potentially as a result of atherothrombotic events. However, none of the genotypes investigated were independently associated with mortality.
authors.affiliation: Department of Cardiovascular Surgery, Nicosia State Hospital, Nalbantoglu Lefkosa Devlet Hastanesi, Ortakoy, Nicosia, Cyprus. ozanemiroglu@gmail.com
authors.forename: Ozan
authors.initials: O
authors.lastname: Emiroglu
authors.forename: Serkan
authors.initials: S
authors.lastname: Durdu
authors.forename: Yonca
authors.initials: Y
authors.lastname: Egin
authors.forename: Ahmet R
authors.initials: AR
authors.lastname: Akar
authors.forename: Yesim D
authors.initials: YD
authors.lastname: Alakoc
authors.forename: Cagin
authors.initials: C
authors.lastname: Zaim
authors.forename: Umit
authors.initials: U
authors.lastname: Ozyurda
authors.forename: Nejat
authors.initials: N
authors.lastname: Akar
mesh_terms: D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000235:genetics* / Q000601:surgery*; D005165:Factor V / Q000235:genetics*; D005260:Female; D005838:Genotype; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D009154:Mutation; D007703:Peptidyl-Dipeptidase A / Q000235:genetics*; D020641:Polymorphism, Single Nucleotide; D011183:Postoperative Complications / Q000235:genetics*; D011237:Predictive Value of Tests; D015995:Prevalence; D011516:Prothrombin / Q000235:genetics*; D060888:Real-Time Polymerase Chain Reaction; D012307:Risk Factors; D018709:Statistics, Nonparametric; D013927:Thrombosis / Q000235:genetics*
chemical_list: C095381:factor V Leiden; D005165:Factor V; D011516:Prothrombin; D007703:Peptidyl-Dipeptidase A