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Platelet PlA2 polymorphism enhances risk of neurocognitive decline after cardiopulmonary bypass. Multicenter Study of Perioperative Ischemia (McSPI) Research Group.

Publication ,  Journal Article
Mathew, JP; Rinder, CS; Howe, JG; Fontes, M; Crouch, J; Newman, MF; Phillips-Bute, B; Smith, BR
Published in: Ann Thorac Surg
February 2001

BACKGROUND: Neurocognitive decline, often produced by atherosclerotic plaque embolization, remains a frequent complication of cardiopulmonary bypass. Plaque fragments may initiate local thrombosis, which, in turn, aggravates the embolic insult. Prothrombotic genetic factors may exacerbate this process. We investigated whether the PlA2 polymorphism of platelet GPIIIa, a prothrombotic risk factor in other cardiovascular settings, is associated with early neurocognitive decline after cardiopulmonary bypass. METHODS: Neurocognitive changes were evaluated by the Mini-Mental State Examination administered preoperatively and on postoperative day 4 and the PlA genotype determined in 70 patients undergoing cardiopulmonary bypass. RESULTS: Forty-nine patients were PlA1/A1, and 21 were PlA1/A2 or PlA2/A2. Fifty-two patients (74%) demonstrated post-cardiopulmonary bypass neurocognitive decline, of which 34 were PlA1/A1 and 18 were PlA1/A2 or PlA2/A2 Multivariate analysis revealed that the PlA2 genotype and baseline Mini-Mental State Examination were significantly associated with greater neurocognitive decline (decreased Mini-Mental State Examination scores, p = 0.036 and 0.024, respectively). CONCLUSIONS: This study demonstrates a link between the PlA2 allele of platelet GPIIIa and more severe neurocognitive decline after cardiopulmonary bypass. Although the mechanism is unknown, it could represent exacerbation of platelet-dependent thrombotic processes associated with plaque embolism.

Duke Scholars

Published In

Ann Thorac Surg

DOI

ISSN

0003-4975

Publication Date

February 2001

Volume

71

Issue

2

Start / End Page

663 / 666

Location

Netherlands

Related Subject Headings

  • Risk Factors
  • Respiratory System
  • Postoperative Complications
  • Polymorphism, Genetic
  • Middle Aged
  • Mental Status Schedule
  • Male
  • Intracranial Embolism
  • Intracranial Arteriosclerosis
  • Integrin beta3
 

Citation

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ICMJE
MLA
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Mathew, J. P., Rinder, C. S., Howe, J. G., Fontes, M., Crouch, J., Newman, M. F., … Smith, B. R. (2001). Platelet PlA2 polymorphism enhances risk of neurocognitive decline after cardiopulmonary bypass. Multicenter Study of Perioperative Ischemia (McSPI) Research Group. Ann Thorac Surg, 71(2), 663–666. https://doi.org/10.1016/s0003-4975(00)02335-3
Mathew, J. P., C. S. Rinder, J. G. Howe, M. Fontes, J. Crouch, M. F. Newman, B. Phillips-Bute, and B. R. Smith. “Platelet PlA2 polymorphism enhances risk of neurocognitive decline after cardiopulmonary bypass. Multicenter Study of Perioperative Ischemia (McSPI) Research Group.Ann Thorac Surg 71, no. 2 (February 2001): 663–66. https://doi.org/10.1016/s0003-4975(00)02335-3.
Mathew JP, Rinder CS, Howe JG, Fontes M, Crouch J, Newman MF, et al. Platelet PlA2 polymorphism enhances risk of neurocognitive decline after cardiopulmonary bypass. Multicenter Study of Perioperative Ischemia (McSPI) Research Group. Ann Thorac Surg. 2001 Feb;71(2):663–6.
Mathew, J. P., et al. “Platelet PlA2 polymorphism enhances risk of neurocognitive decline after cardiopulmonary bypass. Multicenter Study of Perioperative Ischemia (McSPI) Research Group.Ann Thorac Surg, vol. 71, no. 2, Feb. 2001, pp. 663–66. Pubmed, doi:10.1016/s0003-4975(00)02335-3.
Mathew JP, Rinder CS, Howe JG, Fontes M, Crouch J, Newman MF, Phillips-Bute B, Smith BR. Platelet PlA2 polymorphism enhances risk of neurocognitive decline after cardiopulmonary bypass. Multicenter Study of Perioperative Ischemia (McSPI) Research Group. Ann Thorac Surg. 2001 Feb;71(2):663–666.
Journal cover image

Published In

Ann Thorac Surg

DOI

ISSN

0003-4975

Publication Date

February 2001

Volume

71

Issue

2

Start / End Page

663 / 666

Location

Netherlands

Related Subject Headings

  • Risk Factors
  • Respiratory System
  • Postoperative Complications
  • Polymorphism, Genetic
  • Middle Aged
  • Mental Status Schedule
  • Male
  • Intracranial Embolism
  • Intracranial Arteriosclerosis
  • Integrin beta3