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Doctors find gene that lowers post-surgery survival rate

People who have a certain genetic variant may have a lower survival rate after coronary bypass surgery, according to Duke University Medical Center researchers.

Researchers found that common variants in a gene involved with inflammation and blood clot formation were associated with an increased long-term mortality risk. The study, which was published in the Sept. 12 issue of Circulation, looked at two sets of approximately 1,000 patients.

Dr. Mihai Podgoreanu, senior author of the study and assistant professor of anesthesiology at Duke, noted that the study is one of the first of its kind.

“These results are pretty unique in the sense that it is the first robust finding of the genetic signal for increased mortality in this procedure,” Podgoreanu said.

The goal of this study was to examine the extent that individual patients’ genetic codes affected how long they lived after surgery, Dr. Robert Lobato, lead author of the study and instructor in anesthesia at the Cardiovascular Institute at the Stanford School of Medicine, wrote in an email Thursday. He added that changes within the gene have been previously identified as risk factors for coronary artery disease and heart attacks.

The Duke Clinical Research Institute currently offers three therapeutic options when working with patients who have cardiac disease—medical therapy through drugs, angioplasty to open a clotted vessel and surgery, such as the coronary artery bypass procedure. Only a few patients currently undergo genotyping prior to receiving medical care, Lobato said.

However, with the declining cost and increasing availability of genotyping services, Lobato anticipates that an individual’s genetic information will play a crucial role in patient and physician decision-making in the future.

Researchers have not yet been able to superimpose genetic information in order to predict survival rates, Podgoreanu said. Further research is needed to determine exactly how the discovery will benefit the long-term health of individual cardiac surgery patients. It is too soon, he said, for patients to decide whether or not to carry on with the surgery solely based on their genes.

“While the findings may benefit patients someday, the test for this genetic polymorphism is not currently readily available,” said Dr. John Alexander, associate professor of medicine in the cardiology division at Duke. “This is a small step toward ‘personalized’ treatments.”

Lobato added that these results may allow doctors and patients to better understand the risks a patient faces prior to receiving medical care. This study may help individuals and physicians decide whether to use medical or surgical means to manage a disease.

“I think this is an exciting step forward on the path to personalized medicine,” Lobato said. “I am proud that Duke continues to expand the frontiers of medicine, anesthesiology and surgery.”


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