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J Thorac Cardiovasc Surg 2007;134:477-483
© 2007 The American Association for Thoracic Surgery

Surgery for Acquired Cardiovascular Disease

Presence of lipoprotein lipase S447X stop codon affects the magnitude of interleukin 8 release after cardiac surgery with cardiopulmonary bypass

Koray Ak, MD^a,_*, Selim sbir, MD^a, Atike Tekeli, MD^a, Arzu Ergen, PhD^b, Nazan Atalan, MD^c, Selami Dogan, MD^d, Ali Civelek, MD^a, Sinan Arsan, MD^a

^a Marmara University School of Medicine, Department of Cardiovascular Surgery, Istanbul, Turkey
^b Istanbul University School of Medicine, Institute of Experimental Medical Research, Department of Molecular Medicine, Istanbul, Turkey
^c Özel Academic Hospital, Department of Anesthesiology and Reanimation, Istanbul, Turkey
^d Johann Wolfgang Goethe University, Department of Cardiovascular Surgery, Frankfurt Main, Germany.

Received for publication February 10, 2007; revisions received March 1, 2007; accepted for publication March 12, 2007.

^_* Address for reprints: Koray AK, MD, Marmara University Hospital, 34640 Altunizade Istanbul, Turkey. (Email: akkoray{at}hotmail.com).

Objective: Current data suggest that individual genetic predisposition may influence the magnitude of cytokine response and the degree of organ dysfunction after cardiopulmonary bypass. Lipoprotein lipase S447X polymorphism has been shown to be protective against atherosclerosis. The aim of the study was to investigate the effect of lipoprotein lipase S447X polymorphism on cytokine release and early outcome after cardiopulmonary bypass.

Methods: Forty patients who underwent coronary artery bypass grafting with cardiopulmonary bypass were included. Genotyping for lipoprotein lipase S447X polymorphism was performed by polymerase chain reaction. Levels of interleukins 6 and 8 were measured before induction and 6, 24, and 72 hours after operation by enzyme-linked immunosorbent assay. Clinical data were collected prospectively. Daily assessment of organ dysfunction was done according to the cardiac surgery scoring (CASUS) system.

Results: The allele frequency of lipoprotein lipase S447X stop codon was 17.5%. S447X carriers revealed significantly lower interleukin 8 levels at the sixth and 24th postoperative hours than the noncarrier group (P = .005 and P = .041, respectively). Patients in the S447X carrier group had significantly shorter ventilation times than the noncarrier group (P = .048). Also, the S447X carrier group revealed significantly lower postoperative 6-hour lactate levels, operative day, and postoperative day 1 organ dysfunction scores than the other group (P = .001, .005 and .002, respectively).

Conclusion: Lipoprotein lipase S447X stop codon mutation is associated with lower levels of interleukin 8 after coronary artery bypass grafting. Identification of high-risk patients for cardiopulmonary bypass–related systemic inflammation by detecting lipoprotein lipase S447X stop codon polymorphism may improve early postoperative outcome, especially in patients with limited organ reserves.