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A Thrombomodulin Gene Polymorphism (C1418T) Is Associated with Early Outcomes in Patients Undergoing Coronary Artery Bypass Graft Surgery with a Conventional Cardiopulmonary Bypass during Hospitalization

Background: Thrombomodulin (TM) is a type of cell membrane-bound anticoagulant protein cofactor in the thrombin-mediated activation of protein C. Previous evidence has shown an association between TM polymorphisms and systemic inflammation. Conventional cardiopulmonary bypass (CPB), beating-heart CP...

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Autores principales: Pai, Ching-Chou, Lin, Yi-Wen, Tsai, Yi-Ting, Loh, Shih-Hurng, Lin, Chih-Yuan, Lin, Chin-Sheng, Lin, Yi-Chang, Ke, Hung-Yen, Lin, Feng-Yen, Tsai, Chien-Sung
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5590058/
https://www.ncbi.nlm.nih.gov/pubmed/28930238
http://dx.doi.org/10.3390/medicines4020022
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author Pai, Ching-Chou
Lin, Yi-Wen
Tsai, Yi-Ting
Loh, Shih-Hurng
Lin, Chih-Yuan
Lin, Chin-Sheng
Lin, Yi-Chang
Ke, Hung-Yen
Lin, Feng-Yen
Tsai, Chien-Sung
author_facet Pai, Ching-Chou
Lin, Yi-Wen
Tsai, Yi-Ting
Loh, Shih-Hurng
Lin, Chih-Yuan
Lin, Chin-Sheng
Lin, Yi-Chang
Ke, Hung-Yen
Lin, Feng-Yen
Tsai, Chien-Sung
author_sort Pai, Ching-Chou
collection PubMed
description Background: Thrombomodulin (TM) is a type of cell membrane-bound anticoagulant protein cofactor in the thrombin-mediated activation of protein C. Previous evidence has shown an association between TM polymorphisms and systemic inflammation. Conventional cardiopulmonary bypass (CPB), beating-heart CPB, and off-pump techniques have been widely used in cardiac surgery. However, these techniques may also cause systemic inflammatory responses in the patients. Whether TM polymorphisms are associated with systemic inflammation after cardiac surgery is still unclear. Methods: We analyzed the TM gene C1418T polymorphisms in 347 patients who underwent coronary artery bridge graft (CABG) surgery using allele-specific primers in a PCR assay. The clinical data during the hospital stay were collected and tested for correlations with the TM gene C1418T polymorphisms. Results: We separated the patients into two groups based on their TM C1418T genotype (CC genotype group and CT/TT genotype group). The days spent in an intensive care unit (ICU) and the incidence of fever in the ICU were significantly lower in the beating-heart CPB and off-pump groups than in the conventional CPB group. Additionally, the TM gene C1418T polymorphisms did not affect the early outcomes in patients in the beating-heart CPB and off-pump groups. Interestingly, in the conventional CPB group, patients with the CC genotype had a lower rate of fever, shorter duration of fever, and delay of ICU when compared with the CT/TT genotype. Conclusion: Surgeons may use a patient’s TM gene C1418T polymorphism to predict the strength of systemic inflammation and speculate on early outcomes during hospitalization before conventional CPB is performed.
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spelling pubmed-55900582017-09-14 A Thrombomodulin Gene Polymorphism (C1418T) Is Associated with Early Outcomes in Patients Undergoing Coronary Artery Bypass Graft Surgery with a Conventional Cardiopulmonary Bypass during Hospitalization Pai, Ching-Chou Lin, Yi-Wen Tsai, Yi-Ting Loh, Shih-Hurng Lin, Chih-Yuan Lin, Chin-Sheng Lin, Yi-Chang Ke, Hung-Yen Lin, Feng-Yen Tsai, Chien-Sung Medicines (Basel) Article Background: Thrombomodulin (TM) is a type of cell membrane-bound anticoagulant protein cofactor in the thrombin-mediated activation of protein C. Previous evidence has shown an association between TM polymorphisms and systemic inflammation. Conventional cardiopulmonary bypass (CPB), beating-heart CPB, and off-pump techniques have been widely used in cardiac surgery. However, these techniques may also cause systemic inflammatory responses in the patients. Whether TM polymorphisms are associated with systemic inflammation after cardiac surgery is still unclear. Methods: We analyzed the TM gene C1418T polymorphisms in 347 patients who underwent coronary artery bridge graft (CABG) surgery using allele-specific primers in a PCR assay. The clinical data during the hospital stay were collected and tested for correlations with the TM gene C1418T polymorphisms. Results: We separated the patients into two groups based on their TM C1418T genotype (CC genotype group and CT/TT genotype group). The days spent in an intensive care unit (ICU) and the incidence of fever in the ICU were significantly lower in the beating-heart CPB and off-pump groups than in the conventional CPB group. Additionally, the TM gene C1418T polymorphisms did not affect the early outcomes in patients in the beating-heart CPB and off-pump groups. Interestingly, in the conventional CPB group, patients with the CC genotype had a lower rate of fever, shorter duration of fever, and delay of ICU when compared with the CT/TT genotype. Conclusion: Surgeons may use a patient’s TM gene C1418T polymorphism to predict the strength of systemic inflammation and speculate on early outcomes during hospitalization before conventional CPB is performed. MDPI 2017-04-23 /pmc/articles/PMC5590058/ /pubmed/28930238 http://dx.doi.org/10.3390/medicines4020022 Text en © 2017 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Pai, Ching-Chou
Lin, Yi-Wen
Tsai, Yi-Ting
Loh, Shih-Hurng
Lin, Chih-Yuan
Lin, Chin-Sheng
Lin, Yi-Chang
Ke, Hung-Yen
Lin, Feng-Yen
Tsai, Chien-Sung
A Thrombomodulin Gene Polymorphism (C1418T) Is Associated with Early Outcomes in Patients Undergoing Coronary Artery Bypass Graft Surgery with a Conventional Cardiopulmonary Bypass during Hospitalization
title A Thrombomodulin Gene Polymorphism (C1418T) Is Associated with Early Outcomes in Patients Undergoing Coronary Artery Bypass Graft Surgery with a Conventional Cardiopulmonary Bypass during Hospitalization
title_full A Thrombomodulin Gene Polymorphism (C1418T) Is Associated with Early Outcomes in Patients Undergoing Coronary Artery Bypass Graft Surgery with a Conventional Cardiopulmonary Bypass during Hospitalization
title_fullStr A Thrombomodulin Gene Polymorphism (C1418T) Is Associated with Early Outcomes in Patients Undergoing Coronary Artery Bypass Graft Surgery with a Conventional Cardiopulmonary Bypass during Hospitalization
title_full_unstemmed A Thrombomodulin Gene Polymorphism (C1418T) Is Associated with Early Outcomes in Patients Undergoing Coronary Artery Bypass Graft Surgery with a Conventional Cardiopulmonary Bypass during Hospitalization
title_short A Thrombomodulin Gene Polymorphism (C1418T) Is Associated with Early Outcomes in Patients Undergoing Coronary Artery Bypass Graft Surgery with a Conventional Cardiopulmonary Bypass during Hospitalization
title_sort thrombomodulin gene polymorphism (c1418t) is associated with early outcomes in patients undergoing coronary artery bypass graft surgery with a conventional cardiopulmonary bypass during hospitalization
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5590058/
https://www.ncbi.nlm.nih.gov/pubmed/28930238
http://dx.doi.org/10.3390/medicines4020022
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