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Cognitive Function after Major Noncardiac Surgery, Apolipoprotein E4 Genotype, and Biomarkers of Brain Injury

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Bibliographische Detailangaben
Zeitschriftentitel: Anesthesiology
Personen und Körperschaften: McDonagh, David L., Mathew, Joseph P., White, Willam D., Phillips-Bute, Barbara, Laskowitz, Daniel T., Podgoreanu, Mihai V., Newman, Mark F.
In: Anesthesiology, 112, 2010, 4, S. 852-859
Medientyp: E-Article
Sprache: Englisch
veröffentlicht:
Ovid Technologies (Wolters Kluwer Health)
Schlagwörter:
author_facet McDonagh, David L.
Mathew, Joseph P.
White, Willam D.
Phillips-Bute, Barbara
Laskowitz, Daniel T.
Podgoreanu, Mihai V.
Newman, Mark F.
McDonagh, David L.
Mathew, Joseph P.
White, Willam D.
Phillips-Bute, Barbara
Laskowitz, Daniel T.
Podgoreanu, Mihai V.
Newman, Mark F.
author McDonagh, David L.
Mathew, Joseph P.
White, Willam D.
Phillips-Bute, Barbara
Laskowitz, Daniel T.
Podgoreanu, Mihai V.
Newman, Mark F.
spellingShingle McDonagh, David L.
Mathew, Joseph P.
White, Willam D.
Phillips-Bute, Barbara
Laskowitz, Daniel T.
Podgoreanu, Mihai V.
Newman, Mark F.
Anesthesiology
Cognitive Function after Major Noncardiac Surgery, Apolipoprotein E4 Genotype, and Biomarkers of Brain Injury
Anesthesiology and Pain Medicine
author_sort mcdonagh, david l.
spelling McDonagh, David L. Mathew, Joseph P. White, Willam D. Phillips-Bute, Barbara Laskowitz, Daniel T. Podgoreanu, Mihai V. Newman, Mark F. 0003-3022 Ovid Technologies (Wolters Kluwer Health) Anesthesiology and Pain Medicine http://dx.doi.org/10.1097/aln.0b013e3181d31fd7 <jats:sec> <jats:title>Background</jats:title> <jats:p>Postoperative cognitive dysfunction (POCD) is a significant cause of morbidity after noncardiac surgery. Identified risk factors are largely limited to demographic characteristics. We hypothesized that POCD was associated with apolipoprotein E4 (APOE4) genotype and plasma biomarkers of brain injury and inflammation.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>Three hundred ninety-four patients older than 55 yr undergoing major elective noncardiac surgery were enrolled in this prospective observational study. Apolipoprotein E genotyping was performed at baseline. Plasma was collected at baseline and end of surgery and at 4.5, 24, and 48-h postoperatively. Six protein biomarkers were assayed (B-type natriuretic peptide, C-reactive protein, D-dimer, matrix metalloproteinase-9, neuron-specific enolase, and S-100B). Neurocognitive testing was conducted at baseline and at 6 weeks and 1 yr after surgery; scores were subjected to factor analysis. The association of APOE4 and biomarkers with POCD was tested using multivariable regression modeling.</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>Three hundred fifty patients (89%) completed 6-week neurocognitive testing. POCD occurred in 54.3% of participants at 6 weeks and 46.1% at 1 yr. There was no difference in POCD between patients with or without the APOE4 allele (56.6 vs. 52.6%; P = 0.58). The continuous cognitive change score (mean +/- SD) was similar between groups (APOE4: 0.05 +/- 0.27 vs. non-APOE4: 0.07 +/- 0.28; P = 0.53). Two hundred ninety-one subjects (74%) completed testing at 1 yr. POCD occurred in 45.9% of APOE4 subjects versus 46.3% of non-APOE4 subjects (P = 0.95). The cognitive score was again similar (APOE4: 0.08 +/- 0.27 vs. non-APOE4: 0.05 +/- 0.25; P = 0.39). Biomarker levels were not associated with APOE4 genotype or cognition at 6 weeks or 1 yr.</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusion</jats:title> <jats:p>Cognitive decline after major noncardiac surgery is not associated with APOE4 genotype or plasma biomarker levels.</jats:p> </jats:sec> Cognitive Function after Major Noncardiac Surgery, Apolipoprotein E4 Genotype, and Biomarkers of Brain Injury Anesthesiology
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title Cognitive Function after Major Noncardiac Surgery, Apolipoprotein E4 Genotype, and Biomarkers of Brain Injury
title_unstemmed Cognitive Function after Major Noncardiac Surgery, Apolipoprotein E4 Genotype, and Biomarkers of Brain Injury
title_full Cognitive Function after Major Noncardiac Surgery, Apolipoprotein E4 Genotype, and Biomarkers of Brain Injury
title_fullStr Cognitive Function after Major Noncardiac Surgery, Apolipoprotein E4 Genotype, and Biomarkers of Brain Injury
title_full_unstemmed Cognitive Function after Major Noncardiac Surgery, Apolipoprotein E4 Genotype, and Biomarkers of Brain Injury
title_short Cognitive Function after Major Noncardiac Surgery, Apolipoprotein E4 Genotype, and Biomarkers of Brain Injury
title_sort cognitive function after major noncardiac surgery, apolipoprotein e4 genotype, and biomarkers of brain injury
topic Anesthesiology and Pain Medicine
url http://dx.doi.org/10.1097/aln.0b013e3181d31fd7
publishDate 2010
physical 852-859
description <jats:sec> <jats:title>Background</jats:title> <jats:p>Postoperative cognitive dysfunction (POCD) is a significant cause of morbidity after noncardiac surgery. Identified risk factors are largely limited to demographic characteristics. We hypothesized that POCD was associated with apolipoprotein E4 (APOE4) genotype and plasma biomarkers of brain injury and inflammation.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>Three hundred ninety-four patients older than 55 yr undergoing major elective noncardiac surgery were enrolled in this prospective observational study. Apolipoprotein E genotyping was performed at baseline. Plasma was collected at baseline and end of surgery and at 4.5, 24, and 48-h postoperatively. Six protein biomarkers were assayed (B-type natriuretic peptide, C-reactive protein, D-dimer, matrix metalloproteinase-9, neuron-specific enolase, and S-100B). Neurocognitive testing was conducted at baseline and at 6 weeks and 1 yr after surgery; scores were subjected to factor analysis. The association of APOE4 and biomarkers with POCD was tested using multivariable regression modeling.</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>Three hundred fifty patients (89%) completed 6-week neurocognitive testing. POCD occurred in 54.3% of participants at 6 weeks and 46.1% at 1 yr. There was no difference in POCD between patients with or without the APOE4 allele (56.6 vs. 52.6%; P = 0.58). The continuous cognitive change score (mean +/- SD) was similar between groups (APOE4: 0.05 +/- 0.27 vs. non-APOE4: 0.07 +/- 0.28; P = 0.53). Two hundred ninety-one subjects (74%) completed testing at 1 yr. POCD occurred in 45.9% of APOE4 subjects versus 46.3% of non-APOE4 subjects (P = 0.95). The cognitive score was again similar (APOE4: 0.08 +/- 0.27 vs. non-APOE4: 0.05 +/- 0.25; P = 0.39). Biomarker levels were not associated with APOE4 genotype or cognition at 6 weeks or 1 yr.</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusion</jats:title> <jats:p>Cognitive decline after major noncardiac surgery is not associated with APOE4 genotype or plasma biomarker levels.</jats:p> </jats:sec>
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author McDonagh, David L., Mathew, Joseph P., White, Willam D., Phillips-Bute, Barbara, Laskowitz, Daniel T., Podgoreanu, Mihai V., Newman, Mark F.
author_facet McDonagh, David L., Mathew, Joseph P., White, Willam D., Phillips-Bute, Barbara, Laskowitz, Daniel T., Podgoreanu, Mihai V., Newman, Mark F., McDonagh, David L., Mathew, Joseph P., White, Willam D., Phillips-Bute, Barbara, Laskowitz, Daniel T., Podgoreanu, Mihai V., Newman, Mark F.
author_sort mcdonagh, david l.
container_issue 4
container_start_page 852
container_title Anesthesiology
container_volume 112
description <jats:sec> <jats:title>Background</jats:title> <jats:p>Postoperative cognitive dysfunction (POCD) is a significant cause of morbidity after noncardiac surgery. Identified risk factors are largely limited to demographic characteristics. We hypothesized that POCD was associated with apolipoprotein E4 (APOE4) genotype and plasma biomarkers of brain injury and inflammation.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>Three hundred ninety-four patients older than 55 yr undergoing major elective noncardiac surgery were enrolled in this prospective observational study. Apolipoprotein E genotyping was performed at baseline. Plasma was collected at baseline and end of surgery and at 4.5, 24, and 48-h postoperatively. Six protein biomarkers were assayed (B-type natriuretic peptide, C-reactive protein, D-dimer, matrix metalloproteinase-9, neuron-specific enolase, and S-100B). Neurocognitive testing was conducted at baseline and at 6 weeks and 1 yr after surgery; scores were subjected to factor analysis. The association of APOE4 and biomarkers with POCD was tested using multivariable regression modeling.</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>Three hundred fifty patients (89%) completed 6-week neurocognitive testing. POCD occurred in 54.3% of participants at 6 weeks and 46.1% at 1 yr. There was no difference in POCD between patients with or without the APOE4 allele (56.6 vs. 52.6%; P = 0.58). The continuous cognitive change score (mean +/- SD) was similar between groups (APOE4: 0.05 +/- 0.27 vs. non-APOE4: 0.07 +/- 0.28; P = 0.53). Two hundred ninety-one subjects (74%) completed testing at 1 yr. POCD occurred in 45.9% of APOE4 subjects versus 46.3% of non-APOE4 subjects (P = 0.95). The cognitive score was again similar (APOE4: 0.08 +/- 0.27 vs. non-APOE4: 0.05 +/- 0.25; P = 0.39). Biomarker levels were not associated with APOE4 genotype or cognition at 6 weeks or 1 yr.</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusion</jats:title> <jats:p>Cognitive decline after major noncardiac surgery is not associated with APOE4 genotype or plasma biomarker levels.</jats:p> </jats:sec>
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spelling McDonagh, David L. Mathew, Joseph P. White, Willam D. Phillips-Bute, Barbara Laskowitz, Daniel T. Podgoreanu, Mihai V. Newman, Mark F. 0003-3022 Ovid Technologies (Wolters Kluwer Health) Anesthesiology and Pain Medicine http://dx.doi.org/10.1097/aln.0b013e3181d31fd7 <jats:sec> <jats:title>Background</jats:title> <jats:p>Postoperative cognitive dysfunction (POCD) is a significant cause of morbidity after noncardiac surgery. Identified risk factors are largely limited to demographic characteristics. We hypothesized that POCD was associated with apolipoprotein E4 (APOE4) genotype and plasma biomarkers of brain injury and inflammation.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>Three hundred ninety-four patients older than 55 yr undergoing major elective noncardiac surgery were enrolled in this prospective observational study. Apolipoprotein E genotyping was performed at baseline. Plasma was collected at baseline and end of surgery and at 4.5, 24, and 48-h postoperatively. Six protein biomarkers were assayed (B-type natriuretic peptide, C-reactive protein, D-dimer, matrix metalloproteinase-9, neuron-specific enolase, and S-100B). Neurocognitive testing was conducted at baseline and at 6 weeks and 1 yr after surgery; scores were subjected to factor analysis. The association of APOE4 and biomarkers with POCD was tested using multivariable regression modeling.</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>Three hundred fifty patients (89%) completed 6-week neurocognitive testing. POCD occurred in 54.3% of participants at 6 weeks and 46.1% at 1 yr. There was no difference in POCD between patients with or without the APOE4 allele (56.6 vs. 52.6%; P = 0.58). The continuous cognitive change score (mean +/- SD) was similar between groups (APOE4: 0.05 +/- 0.27 vs. non-APOE4: 0.07 +/- 0.28; P = 0.53). Two hundred ninety-one subjects (74%) completed testing at 1 yr. POCD occurred in 45.9% of APOE4 subjects versus 46.3% of non-APOE4 subjects (P = 0.95). The cognitive score was again similar (APOE4: 0.08 +/- 0.27 vs. non-APOE4: 0.05 +/- 0.25; P = 0.39). Biomarker levels were not associated with APOE4 genotype or cognition at 6 weeks or 1 yr.</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusion</jats:title> <jats:p>Cognitive decline after major noncardiac surgery is not associated with APOE4 genotype or plasma biomarker levels.</jats:p> </jats:sec> Cognitive Function after Major Noncardiac Surgery, Apolipoprotein E4 Genotype, and Biomarkers of Brain Injury Anesthesiology
spellingShingle McDonagh, David L., Mathew, Joseph P., White, Willam D., Phillips-Bute, Barbara, Laskowitz, Daniel T., Podgoreanu, Mihai V., Newman, Mark F., Anesthesiology, Cognitive Function after Major Noncardiac Surgery, Apolipoprotein E4 Genotype, and Biomarkers of Brain Injury, Anesthesiology and Pain Medicine
title Cognitive Function after Major Noncardiac Surgery, Apolipoprotein E4 Genotype, and Biomarkers of Brain Injury
title_full Cognitive Function after Major Noncardiac Surgery, Apolipoprotein E4 Genotype, and Biomarkers of Brain Injury
title_fullStr Cognitive Function after Major Noncardiac Surgery, Apolipoprotein E4 Genotype, and Biomarkers of Brain Injury
title_full_unstemmed Cognitive Function after Major Noncardiac Surgery, Apolipoprotein E4 Genotype, and Biomarkers of Brain Injury
title_short Cognitive Function after Major Noncardiac Surgery, Apolipoprotein E4 Genotype, and Biomarkers of Brain Injury
title_sort cognitive function after major noncardiac surgery, apolipoprotein e4 genotype, and biomarkers of brain injury
title_unstemmed Cognitive Function after Major Noncardiac Surgery, Apolipoprotein E4 Genotype, and Biomarkers of Brain Injury
topic Anesthesiology and Pain Medicine
url http://dx.doi.org/10.1097/aln.0b013e3181d31fd7