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- Title
Association between 4G/5G polymorphism of the plasminogen activator inhibitor 1 gene with stroke or encephalopathy after cardiac surgery.
- Authors
Sirgo, Gonzalo; Pérez-Vela, José Luis; Morales, Pablo; Del Rey, Manuel; Vendrell, Joan; Gutierrez, Cristina; Rello, Jordi; Pérez-Vela, José Luis
- Abstract
<bold>Objective: </bold>To evaluate whether the 4G/5G polymorphism of the plasminogen activator inhibitor 1 gene increases the risk of thromboembolic neurological complications, and, if so, whether these complications lengthen the period of mechanical ventilation and hospital stay.<bold>Design: </bold>Prospective, case-control study in a 14 bed surgical intensive care unit of a university hospital.<bold>Patients: </bold>260 consecutive patients who underwent cardiac surgery with cardiopulmonary bypass and 111 controls.<bold>Interventions: </bold>DNA was isolated and 4G/5G polymorphism was typed using RFLP methodology.<bold>Measurements and Results: </bold>Genetic analysis revealed 4G/5G in 131 patients (50.4%), 5G/5G genotype in 82 (31.5%), and 4G/4G in only 47 (18.1%). Prevalence of neurological complications was 20.8% (n=54) (stroke 5.4%, n=14; encephalopathy 15.4%, n=40]. A trend towards higher risk of developing stroke (8.5% vs. 4.7%, RR 1.9) and a significant twofold increase in encephalopathy (27.7% vs. 12.7%; RR 2.6) was documented in 4G/4G carriers. Multivariate analysis showed that development of stroke or encephalopathy was independently associated with prolonged mechanical ventilation (OR 20), and that neurological complication (OR 2.4) and 4G/4G genotype (OR 2.6) were independently associated with hospital stay of 2 weeks or longer.<bold>Conclusions: </bold>The 4G/4G genotype can increase the risk of thromboembolic neurological complications after cardiac surgery with cardiopulmonary by-pass. The neurological complications result in longer time on ventilator and longer hospital stay.
- Subjects
SPAIN; PLASMINOGEN activators; CEREBROVASCULAR disease; CARDIAC surgery; THROMBOEMBOLISM; CARDIOPULMONARY bypass; INTENSIVE care units; BLOOD coagulation factors; CEREBRAL ischemia; THORACIC surgery; COMPARATIVE studies; GENETIC polymorphisms; LENGTH of stay in hospitals; LONGITUDINAL method; RESEARCH methodology; MEDICAL cooperation; PSYCHOLOGICAL tests; RESEARCH; STROKE; EVALUATION research
- Publication
Intensive Care Medicine, 2006, Vol 32, Issue 5, p668
- ISSN
0342-4642
- Publication type
journal article
- DOI
10.1007/s00134-006-0092-y