The eNOS 894G/T gene polymorphism and its influence on early and long-term mortality after on-pump cardiac surgery

Abstract

BackgroundThe eNOS 894G/T polymorphism (GG, GT, and TT) is associated with cardiovascular mortality and may influence cardiovascular diseases as a genetic risk factor. Moreover, this polymorphism has an impact on intraoperative hemodynamics during cardiac surgery with cardiopulmonary bypass (CPB). In this study, we analyzed the influence of this gene polymorphism on early clinical outcome in patients who underwent cardiac surgery with CPB. Also, we performed a 5-year follow-up, assessing the impact of this polymorphism on long-term mortality.Method500 patients who underwent cardiac surgery with CPB between 2006 and 2007 were included in this prospective single centre study. Genotyping for the eNOS gene polymorphism was performed by polymerase chain reaction amplification.ResultsGenotype distribution of 894G/T was: GG 50.2%; GT 42.2%; TT 7.8%. Cardiovascular risk factors were equally distributed between the different genotypes of the eNOS 894G/T polymorphism. No significant difference among the groups was shown regarding Euroscore, SAPS II and APACHE II. Perioperative characteristics were also not affected by the genotypes, except for the consumption of norepinephrine (p = 0.03) and amiodarone (p = 0.01) which was higher in the GT allele carrier. The early postoperative course was quite uniform across the genotypes, except for mean intensive care unit length of stay which was significantly prolonged in GT carriers (p = 0.001). The five-year follow-up was 100% complete and showed no significant differences regarding mortality between the groups.ConclusionOur results show that the eNOS 894G /T polymorphism is not associated with early and late clinical outcome after cardiac surgery. Thus, this polymorphism can actually not help to identify high risk groups in the heterogeneous population of individuals who undergo cardiac surgery with CPB.

Endothelial nitric oxide synthase polymorphism and prognosis in systolic heart failure patients

“…A recent study demonstrated a similarly significant association between the T allele genotype and prevalence of non-ischemic dilated cardiomyopathy [33]. In contrast to these results, a long-term follow-up of patients after cardiac surgery did not show increased risk for mortality in subjects who were homozygous T-allele carriers [48]. Moreover, several reports, including ours on this cohort of HF patients, have previously demonstrated a significant correlation between the G allele of the eNOS G894GT polymorphism and the presence of atrial fibrillation in systolic HF populations, which may indicate a more progressive disease [34][35][36][37].…”

Research Article Polymorphisms of the genes <i>eNOS</i>, <i>GSTT1</i> and <i>GSTM1</i> are significantly associated with atherosclerotic disease in hypertensive patients

“…In our investigation, analysis of the distribution of the G and T alleles of the G894T eNOS polymorphism in the case and control groups showed no significant difference. A study carried out by Hinz et al (2013) that evaluated the influence of G894T polymorphism in the early clinical evolution of patients submitted to cardiac surgery found no significant difference between case and control groups. Regarding hypertension and G894T polymorphism, Niu et al (2011) analyzed 19,284 patients in the case group and 26,003 in the control group.…”

Genetic Markers of Systemic Inflammatory Response in Cardiac Surgery (Review)

“…The five-year follow-up demonstrated no significant differences in the mortality rates between the groups. Based on the obtained results the authors concluded that this polymorphism can not be used as a marker to identify high risk groups in heterogeneous patient population undergoing a cardiac surgery with CPB [42]. A summary of all genes described in this review is presented in Table. Concluding the results of the literature search, we found that there was a very limited number of articles describing non-infectious SIRS in patients undergoing a cardiovascular surgery, including CABG, who are carriers of different alleles in genes involved in the inflammatory response [31][32][33][34][35][36][37][38][39][40].…”

“…J. Hinz et al (2013) [42] analyzed the influence of the eNOS 894G/T gene variable site polymorphism on early clinical outcome in patients who underwent cardiac surgery with CPB. 500 Caucasian patients were enrolled in the study.…”

“…r e a n i m a t o l o g y . c o m [42] проанализировано влияние полиморфизма вариабельного сайта eNOS 894 G/T на клинические исходы у пациентов, перенесших операции на сердце в условиях ИК. В исследование было включено 500 европеоидов.…”