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Medicines 2017, 4(2), 22; doi:10.3390/medicines4020022

A Thrombomodulin Gene Polymorphism (C1418T) Is Associated with Early Outcomes in Patients Undergoing Coronary Artery Bypass Graft Surgery with a Conventional Cardiopulmonary Bypass during Hospitalization

1
Division of Cardiovascular Surgery, Department of Surgery, Show-Chwan Memorial Hospital, Changhua 500, Taiwan
2
Division of Cardiovascular Surgery, Department of Surgery, Chi-Mei Medical Center, Tainan 710, Taiwan
3
Division of Cardiovascular Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 114 , Taiwan
4
Institute of Oral Biology, National Yang-Ming University, Taipei 112, Taiwan
5
Division of Cardiology and Cardiovascular Research Center, Taipei Medical University Hospital, Taipei 110, Taiwan
6
Department and Graduate Institute of Pharmacology, National Defense Medical Center, Taipei 114, Taiwan
7
Division of Cardiology, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan
8
Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan
9
Division of Cardiovascular Surgery, Department of Surgery, Taoyuan Armed Forces General Hospital, Taoyuan 325, Taiwan
*
Authors to whom correspondence should be addressed.
Academic Editor: Gerhard Litscher
Received: 9 February 2017 / Revised: 20 April 2017 / Accepted: 20 April 2017 / Published: 23 April 2017
View Full-Text   |   Download PDF [291 KB, uploaded 23 April 2017]

Abstract

Background: Thrombomodulin (TM) is a type of cell membrane-bound anticoagulant protein cofactor in the thrombin-mediated activation of protein C. Previous evidence has shown an association between TM polymorphisms and systemic inflammation. Conventional cardiopulmonary bypass (CPB), beating-heart CPB, and off-pump techniques have been widely used in cardiac surgery. However, these techniques may also cause systemic inflammatory responses in the patients. Whether TM polymorphisms are associated with systemic inflammation after cardiac surgery is still unclear. Methods: We analyzed the TM gene C1418T polymorphisms in 347 patients who underwent coronary artery bridge graft (CABG) surgery using allele-specific primers in a PCR assay. The clinical data during the hospital stay were collected and tested for correlations with the TM gene C1418T polymorphisms. Results: We separated the patients into two groups based on their TM C1418T genotype (CC genotype group and CT/TT genotype group). The days spent in an intensive care unit (ICU) and the incidence of fever in the ICU were significantly lower in the beating-heart CPB and off-pump groups than in the conventional CPB group. Additionally, the TM gene C1418T polymorphisms did not affect the early outcomes in patients in the beating-heart CPB and off-pump groups. Interestingly, in the conventional CPB group, patients with the CC genotype had a lower rate of fever, shorter duration of fever, and delay of ICU when compared with the CT/TT genotype. Conclusion: Surgeons may use a patient’s TM gene C1418T polymorphism to predict the strength of systemic inflammation and speculate on early outcomes during hospitalization before conventional CPB is performed. View Full-Text
Keywords: throbomodulin; cardiopulmonary bypass; polymorphism throbomodulin; cardiopulmonary bypass; polymorphism
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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MDPI and ACS Style

Pai, C.-C.; Lin, Y.-W.; Tsai, Y.-T.; Loh, S.-H.; Lin, C.-Y.; Lin, C.-S.; Lin, Y.-C.; Ke, H.-Y.; Lin, F.-Y.; Tsai, C.-S. A Thrombomodulin Gene Polymorphism (C1418T) Is Associated with Early Outcomes in Patients Undergoing Coronary Artery Bypass Graft Surgery with a Conventional Cardiopulmonary Bypass during Hospitalization. Medicines 2017, 4, 22.

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