This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (5) Citing Articles via Google Scholar Google Scholar Articles by Kofke, W. A. Articles by Cheung, A. Search for Related Content PubMed PubMed Citation Articles by Kofke, W. A. Articles by Cheung, A. Related Collections Cardiovascular Heart Neuroanesthesia Complications

---

CARDIOVASCULAR ANESTHESIA

The Effect of Apolipoprotein E Genotype on Neuron Specific Enolase and S-100ß Levels After Cardiac Surgery

Department of Anesthesia, University of Pennsylvania, Philadelphia, Pennsylvania

Address correspondence to W. Andrew Kofke, MD, MBA, FCCM, Department of Anesthesia, University of Pennsylvania, 7 Dulles, 3400 Spruce St, Philadelphia, PA 19104–4283. Address email to kofkea{at}uphs.upenn.edu

We tested the hypothesis that two biochemical markers of brain injury would be increased after cardiac surgery in patients with the apolipoprotein (Apo) 4 allele. Arterial blood samples were drawn before and 8 and 24 h after induction of anesthesia and later assayed for neuron specific enolase (NSE), S-100ß, and apoE genotype. There was a highly significant temporal effect with increases in NSE (2.2 ± 1.6 ng/L to 11.8 ± 8.9 ng/L; P < 0.0001) (mean ± SD) and S-100ß (0.15 ± 0.1 µg/L to 0.45 ± 0.42 µg/L, P < 0.0001). At 8 and 24 h after induction of anesthesia S-100ß (0.28 ± 0.18 µg/L versus 0.91 ± 0.54 µg/L; P =0.004) and NSE (8.6 ± 5.6 ng/L versus 19.0 ± 19.7 ng/L; P = 0.02) levels, respectively, were higher in patients with the Apo4 allele. Patients with the Apo4 allele may be more susceptible to perioperative neural insults.

IMPLICATIONS: Two blood tests thought to be biomarkers for brain injury were found to be increased after cardiac surgery with larger increases in patients with the apolipoprotein 4 gene, a gene linked to Alzheimer’s disease. There may be genetic differences in susceptibility to neurologic problems after surgery.

This article has been cited by other articles:

				W. A. Kofke, P. A. Blissitt, H. Rao, J. Wang, K. Addya, and J. Detre Remifentanil-Induced Cerebral Blood Flow Effects in Normal Humans: Dose and ApoE Genotype Anesth. Analg., July 1, 2007; 105(1): 167 - 175. [Abstract] [Full Text] [PDF]

				A. M. Sheikh, C. Barrett, N. Villamizar, O. Alzate, S. Miller, J. Shelburne, A. Lodge, J. Lawson, and J. Jaggers Proteomics of cerebral injury in a neonatal model of cardiopulmonary bypass with deep hypothermic circulatory arrest J. Thorac. Cardiovasc. Surg., October 1, 2006; 132(4): 820 - 828. [Abstract] [Full Text] [PDF]

				W. A. Kofke, A. T. Cheung, J. G. Augoustides, J. G. Hecker, and J. Bavaria S-100 and NSE Changes After Cardiac Surgery: Evaluation of Multiple Single Nucleotide Polymorphisms. Anesth. Analg., April 1, 2006; 102(4): 1295 - 1296. [Full Text] [PDF]

				H. P. Grocott and G. B. Mackensen Apolipoprotein E Genotype and S100{beta} After Cardiac Surgery: Is Inflammation the Link? Anesth. Analg., June 1, 2005; 100(6): 1869 - 1870. [Full Text] [PDF]