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.
|Number of pages||6|
|Journal||Annals of Thoracic Surgery|
|State||Published - Sep 1997|
Bibliographical noteFunding 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
- Pulmonary and Respiratory Medicine
- Cardiology and Cardiovascular Medicine