title: Influence of PAI-1 gene promoter-675 (4G/5G) polymorphism on fibrinolytic activity after cardiac surgery employing cardiopulmonary bypass.
abstract: OBJECTIVE
  The plasminogen activator inhibitor type-1 (PAI-1) gene promoter contains 675 (4G/5G) polymorphism. The aim of this study was evaluate the effect of the PAI-1 promoter-675 (4G/5G) polymorphism on the concentrations of PAI-1 and tissue plasminogen activator/PAI-1 (t-PA/PAI-1) complex and bleeding volume after on-pump cardiac surgery.
  
  
  METHODS
  A total of 90 patients were included in the study at Pauls Stradins Clinical University Hospital. Seven patients were excluded due to surgical bleeding. Eighty-three patients were classified according to the PAI-1 genotype: 21 patients had the 4G/4G genotype; 42, the 4G/5G genotype; and 20, the 5G/5G genotype. The following fibrinolysis parameters were recorded: the PAI-1 level preoperatively, D-dimer level at 0, 6, and 24 hours after surgery, and t-PA/PAI-1 complex level 24 hours postoperatively. A postoperative bleeding volume was registered in mL 24 hours after surgery.
  
  
  RESULTS
  The patients with the 5G/5G genotype had significantly lower preoperative PAI-1 levels (17 [SD, 10.8] vs. 24 ng/mL [SD, 9.6], P=0.04), higher D-dimer levels at 6 hours (371 [SD, 226] vs. 232 ng/mL [SD, 185], P=0.03) and 24 hours (326 [SD, 207] vs. 209 ng/mL [SD, 160], P=0.04), and greater postoperative blood loss (568 [SD, 192] vs. 432 mL [168], P=0.02) compared with the 4G/4G carriers. There were no significant differences in the levels of the t-PA/PAI-1 complex comparing different genotype groups.
  
  
  CONCLUSIONS
  The carriers of the 5G/5G genotype showed the lower preoperative PAI-1 levels, greater chest tube blood loss, and higher D-dimer levels indicating that the 5G/5G carriers may have enhanced fibrinolysis.
authors: Department of Anesthesiology and Reanimatology, Riga Stradins University, Latvia. agnese_krauze@yahoo.com
authors: Agnese
authors: A
authors: Ozolina
authors: Eva
authors: E
authors: Strike
authors: Inta
authors: I
authors: Jaunalksne
authors: Jelena
authors: J
authors: Serova
authors: Tatjana
authors: T
authors: Romanova
authors: Liene Nikitina
authors: LN
authors: Zake
authors: Olegs
authors: O
authors: Sabelnikovs
authors: Indulis
authors: I
authors: Vanags
mesh_terms: D000293:Adolescent; D000328:Adult; D016063:Blood Loss, Surgical; D002315:Cardiopulmonary Bypass; D015505:Chest Tubes; D005260:Female; D005342:Fibrinolysis / Q000235:genetics*; D006801:Humans; D008297:Male; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood* / Q000235:genetics*; D011110:Polymorphism, Genetic; D011184:Postoperative Period; D057234:Preoperative Period; D011401:Promoter Regions, Genetic / Q000235:genetics; D055815:Young Adult
chemical_list: D017395:Plasminogen Activator Inhibitor 1; C051321:SERPINE1 protein, human