Preliminary report of a genetic basis for cognitive decline after cardiac operations

Barbara E. Tardiff, Mark F. Newman, Ann M. Saunders, Warren J. Strittmatter, James A. Blumenthal, William D. White, Narda D. Croughwell, R. Duane Davis, Allen D. Roses, Joseph G. Reves

Research output: Contribution to journalArticlepeer-review

251 Scopus citations


Background. Changes in memory and cognition frequently follow cardiac operations. We hypothesized that patients with the apolipoprotein E-ε4 allele are genetically predisposed to cognitive dysfunction after cardiac operations. : Methods. The apolipoprotein E-ε4 allele was evaluated as a predictor variable for postoperative cognitive dysfunction in 65 patients undergoing cardiac bypass grafting at Duke University Medical Center. The primary outcome measure was performance on a cognitive battery administered preoperatively and at 6 weeks postoperatively. Results. In a multivariable logistic regression analysis including apolipoprotein E-ε4, preoperative score, age, and years of education, a significant association was found between apolipoprotein E-ε4 and change in cognitive test score in measures of short-term memory at 6 weeks postoperatively. Patients with lower educational levels were more likely to show a decline in cognitive function associated with the apolipoprotein E-ε4 allele. Conclusions. This study suggests that apolipoprotein E genotype is related to cognitive dysfunction after cardiopulmonary bypass. Cardiac surgical patients may be susceptible to deterioration after physiologic stress as a result of impaired genetically determined neuronal mechanisms of maintenance and repair.

Original languageEnglish
Pages (from-to)715-720
Number of pages6
JournalAnnals of Thoracic Surgery
Issue number3
StatePublished - Sep 1997

Bibliographical note

Funding Information:
This work was supported by The National Institutes of Health, National Institute on Aging, Claude D. Pepper Older Americans Independence Center, #5 P60AG-11268; National Institutes of Health grant ROI-AG-09663; National Institutes of Health Leadership and Excellence Award #5 R35AG-07922; National Institutes of Health Alzheimer’s Disease Research Center #5 P50AG-05128; American Heart Association grant-in-aid #95010970, and a grant from the Anesthesia Patient Safety Foundation.

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine


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