Carriers of the apolipoprotein E epsilon 4 allele are more likely to experience long-term cognitive decline 5 years after cardiac surgery than noncarriers, according to research presented at the American Society of Anesthesiologists’ annual meeting.
“Whether cognitive decline seen after surgery is a side effect of the surgery and anesthesia or a progression of other neurologic disease remains a matter of debate,” Karsten Bartels, MD, fellow in cardiothoracic anesthesiology and critical care medicine at Duke University Medical Center, said in a press release. “Our study found that if a patient has this gene variation (ApoE4), that person is more likely to have cognitive decline 5 years after surgery.”
Previous research has identified ApoE4 as both a driver and marker of accelerated neurologic dysfunction, including in Alzheimer’s disease, according to information in the release.
For this study, researchers reviewed data on 233 white patients (mean age, 64 years) who underwent cardiac surgery. All patients were administered neuropsychological assessments before surgery and 5 years later. Cognitive function was assessed with a composite cognitive index score. The change in cognitive function 5 years after surgery was adjusted for age, education and cognitive score before surgery.
The mean change in cognitive index score in 5 years for patients with the ApoE4 allele was 0.08 and the mean change for patients without the allele was 0.16. These results indicate a less favorable outcome for carriers of the ApoE4 allele, according to the release.
“We report an association between [ApoE4] and long-term neurocognitive function following cardiac surgery. Preoperative identification of patients with [ApoE4] genotype might allow improved risk stratification for patients at risk for cognitive decline,” Bartels and colleagues concluded in the study abstract.
For more information:
Bartels K. Abstract A2024. Presented at: Anesthesiology 2013; Oct. 12-16, 2013; San Francisco.
Disclosure: Cardiology Today could not confirm the researchers’ relevant financial disclosures.