Skip to main content

Vasoplegic syndrome in cardiac surgery: role of synergism between polymorphism of tumor necrosis factor beta and plasminogen activator inhibitor type 1

Introduction

Cardiopulmonary bypass can lead to postoperative hemodynamic disorders. Several genetic polymorphisms have been studied in this setting. We investigated the possible existence of a synergism between polymorphisms of plasminogen activator inhibitor type 1 (PAI-1) and tumoral necrosis factor beta (TNF-B) on hemodynamic response after cardiac surgery

Methods

We prospectively studied the association between hemodynamic response and polymorphisms of TNF-B and PAI-1 in 563 patients undergoing elective cardiac surgery during the years 2008 to 2011. We tested the Hardy-Weinberg equilibrium in the sample. V18 SPSS was used.

Results

We studied 563 patients. We found significant differences in TNF-B polymorphisms regarding norepinephrine requirements at 4 hours (F: 15.9; P < 0.001), post hoc Scheffé (GG vs. AA, 0.32 (0.11 to 0.65) vs. 0.06 (0.04 to 0.09) μg/kg/minute, P < 0.001; GG vs. AG, 0.32 (0.11 to 0.65) vs. 0.06 (0.03 to 0.08), P < 0.001)) and at 24 hours (F: 8; P = 0.005), post hoc Scheffé (GG vs. AA, 0.27 (0.01 to 0.52) vs. 0.10 (0.06 to 0.14), P = 0.019; GG vs. AG, 0.27 (0.01 to 0.52) vs. 0.07 (0.04 to 0.09), P = 0.003)). Unfavorable TNF-B (G homozygous vs. allele A) and PAI-1 unfavorable (4G homozygous vs. allele 5G) were grouped, after adjusting for perioperative significant variables. The homozygous GG and 4G alleles were significant for NA 4 hours (F: 5.5; P = 0.02 and F: 4.1; P = 0.04, respectively) and GG-4G allele interaction (F: 6; P = 0.01) (Figure 1), while for NA at 24 hours statistics showed GG (F: 3.2; P = 0.07), 4G allele (F: 2; P = 0.15) and interaction (F: 3.6, P = 0.05).

figure1

Figure 1

Conclusion

GG homozygous polymorphism TNF-B is associated with an increased dependence on norepinephrine after cardiopulmonary bypass, showing a synergistic action with the 4G allele of PAI-1.

Author information

Affiliations

Authors

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Iribarren, J., Jiménez, J., Perez, N. et al. Vasoplegic syndrome in cardiac surgery: role of synergism between polymorphism of tumor necrosis factor beta and plasminogen activator inhibitor type 1. Crit Care 19, P199 (2015). https://doi.org/10.1186/cc14279

Download citation

Keywords

  • Norepinephrine
  • Significant Variable
  • Emergency Medicine
  • Plasminogen
  • Genetic Polymorphism