Apolipoprotein E genotype, TNF-α 308G/A and risk for cardiac surgery associated-acute kidney injury in Caucasians

Figures & data

Table 1. Demographics ApoE.

	Apo E2 189 (13.4%)	Apo E3 913 (64.5%)	Apo E4 313 (22.1%)	p
Age (years)	66.58 ± 10.03	66.22 ± 11.04	66.49 ± 10.60	0.876
Male	68 (36%)	282 (30.9%)	90 (28.8%)	0.229
Weight (kg)	79.04 ± 14.66	77.94 ± 14.32	77.69 ± 13.50	0.569
Height (cm)	169.6 ± 8.9	170.2 ± 9	170.2 ± 9.1	0.743
LVEF	58.6 ± 14.4	59.7 ± 14.4	59.2 ± 16.2	0.612
PMI	37 (19.7%)	152 (16.7%)	70 (22.4%)	0.070
Atrial fibrillation	42 (22.3%)	160 (17.5%)	48 (15.3%)	0.360
EuroSCORE	4.3 ± 2.5	4.4 ± 2.7	4.5 ± 2.7	0.712
Cardiovascular risk factors
Arterial hypertension	122 (64.6%)	647 (70.9%)	224 (71.6%)	0.285
Diabetes	40 (21.2%)	215 (23.6%)	72 (23%)	0.375
Hyperlipidaemia	94 (49.7%)	523 (57.3%)	174 (55.6%)	0.112
Preoperative medication
Beta-blockers	114 (60.6%)	558 (61.2%)	201 (64.2%)	0.599
Diuretics	79 (42%)	360 (39.5%)	144 (46%)	0.125
ACE-inhibitor	93 (49.5%)	431 (47.3%)	144 (46%)	0.754
Nitrates oral	38 (20.2%)	168 (18.4%)	61 (19.5%)	0.811
Preoperative laboratory findings
Hemoglobin (g/dL)	13.80 ± 1.58	13.76 ± 1.58	13.89 ± 1.61	0.454
Urea (mg/dL)	44.04 ± 20.62	42.36 ± 18.88	43.13 ± 21.80	0.534
Creatinine (mg/dL)	1.12 ± 0.32	1.11 ± 0.32	1.10 ± 0.28	0.856

Notes: LVEF, left ventricular ejection fraction; PMI, previous myocardial infarction; ACE, angiotensin-converting enzyme.

Table 2. Demographics TNF-α-308 G > A.

	TNF 308 A/A 338 (23.9%)	TNF 308 G/A 1007 (71.2%)	TNF 308 G/G 70 (4.9%)	p
Age (years)	65.95 ± 10.60	66.57 ± 10.87	64.63 ± 10.82	0.266
Male	229 (67.8%)	692 (68.7%)	54 (77.1%)	0.309
Weight (kg)	78.91 ± 14.34	77.55 ± 14.06	80.61 ± 14.93	0.098
Height (cm)	170.5 ± 9.3	169.9 ± 9	170.9 ± 7.4	0.518
LVEF	58.9 ± 15.5	59.5 ± 14.7	59.9 ± 13.4	0.750
PMI	59 (17.4%)	187 (18.6%)	13 (18.6%)	0.893
Atrial fibrillation	57 (16.9%)	187 (18.6%)	6 (8.6%)	0.523
EuroSCORE	4.5 ± 2.6	4.4 ± 2.7	3.9 ± 2.7	0.275
Cardiovascular risk factors
Arterial hypertension	232 (68.6%)	710 (70.6%)	51 (72.9%)	0.783
Diabetes	90 (26.6%)	216 (21.5%)	21 (30%)	0.172
Hyperlipidaemia	191 (56.5%)	562 (55.9%)	39 (55.7%)	0.889
Preoperative medication
Beta-blockers	222 (65.7%)	607 (60.4%)	44 (62.9%)	0.221
Diuretics	140 (41.4%)	417 (41.5%)	26 (37.1%)	0.773
ACE-inhibitor	156 (46.2%)	482 (48%)	30 (42.9%)	0.636
Nitrates oral	58 (17.2%)	192 (19.1%)	17 (24.3%)	0.365
Preoperative laboratory findings
Hemoglobin (g/dL)	13.76 ± 1.58	13.81 ± 1.59	13.80 ± 1.66	0.895
Urea (mg/dL)	44.23 ± 22.45	42.20 ± 18.80	42.76 ± 20.04	0.253
Creatinine (mg/dL)	1.11 ± 0.27	1.10 ± 0.32	1.14 ± 0.36	0.658

Notes: LVEF, left ventricular ejection fraction; PMI, previous myocardial infarction; ACE, angiotensin converting enzyme.

Table 3. Procedural and perioperative data for Apo E.

	Apo E2 189 (13.4%)	Apo E3 913 (64.5%)	Apo E4 313 (22.1%)	p
CABG	80 (42.3%)	454 (49.7%)	154 (49.2%)	0.175
Valve	64 (33.9%)	260 (28.5%)	102 (32.6%)	0.189
CABG + valve	27 (14.3%)	134 (14.7%)	38 (12.1%)	0.535
Others	18 (9.5%)	65 (7 a.1%)	19 (6%)	0.404
AoX time (min)	71 ± 30.1	68 ± 28.3	68.3 ± 27.2	0.413
CPB-time (min)	105 ± 41.2	103.6 ± 41.8	103.1 ± 38	0.877
Blood loss (mL)	673 ± 511	661 ± 543	665 ± 499	0.961
Transfused blood (mL)	439 ± 2086	335 ± 864	295 ± 759	0.350
Transfusion receiver	63 (33.3%)	335 (36.7%)	112 (35.8%)	0.678
Postop. ventilation time (h)	20.3 ± 70.8	18.9 ± 83.6	23.4 ± 97.9	0.726
Duration of norepinephrine (d)	1.9 ± 3.5	1.5 ± 2.8	1.7 ± 4.5	0.177
Peak creatinine (mg/dL)	1.31 ± 0.80	1.27 ± 0.66	1.21 ± 0.51	0.246

Notes: CABG, coronary artery bypass grafting; AoX time, aortic cross clamp time; CPB-time, cardiopulmonary bypass time.

Table 4. Procedural and perioperative data for TNF-α-308 G > A.

	TNF 308 A/A 338 (23.9%)	TNF 308 G/A 1007 (71.2%)	TNF 308 G/G 70 (4.9%)	p
CABG^a	158 (46.7%)	489 (48.6%)	41 (58.6%)	0.197
Valve	102 (30.2%)	304 (30.2%)	20 (28.6%)	0.960
CABG + valve	52 (15.4%)	141 (14%)	6 (8.6%)	0.327
Others	27 (7.7%)	73 (7.2%)	3 (4.3%)	0.554
AoX-time (min)	68.1 ± 26.9	69.6 ± 28.1	64.5 ± 28.7	0.267
CPB-time (min)	102.2 ± 37.3	105.5 ± 42	98.7 ± 41.7	0.387
Blood loss (mL)	634 ± 552	673 ± 523	683 ± 487	0.496
Transfusion (mL)	338 ± 851	346 ± 1186	259 ± 574	0.810
Transfusion receiver	123 (36.4%)	368 (36.5%)	19 (27.1%)	0.282
Postop. ventilation time (h)	20.9 ± 82.3	20.5 ± 89.2	9.7 ± 8.5	0.579
Duration of norepinephrine (d)	1.7 ± 4.4	1.5 ± 3.0	1.3 ± 2.5	0.584
Peak creatinine (mg/dL)	1.29 ± 0.71	1.26 ± 0.64	1.22 ± 0.54	0.643

Notes: CABG, coronary artery bypass grafting; AoX time, aortic cross clamp time; CPB-time, cardiopulmonary bypass time.

Figure 1. Maximum creatinine values.

Figure 2. Incidence of perioperative acute kidney injury according to RIFLE criteria (%).

Table 5. Linear regression analysis for postoperative creatinine increase for ApoE.

	Regression coefficient	Standard error	p
a: Apo E2
(Constant)	−0.235	0.090	0.674
AoX-time	−0.004	0.001	<0.001
CPB-time (min)	0.004	0.001	<0.001
LVEF^c	−0.003	0.001	0.004
Baseline creatinine	0.071	0.045	0.117
Transfusion receiver	0.182	0.029	<0.001
Norepinephrine	0.090	0.033	0.007
Apo E2	0.054	0.039	0.169
b: Apo E3
(Constant)	0.037	0.092	0.685
AoX-time^a	−0.004	0.001	<0.001
CPB-time (min)	0.004	0.001	<0.001
LVEF	−0.003	0.001	0.003
Baseline creatinine	0.071	0.045	0.114
Transfusion receiver	0.180	0.029	<0.001
Norepinephrine	0.092	0.033	0.006
Apo E3	0.014	0.028	0.685
c: Apo E4
(Constant)	0.057	0.090	0.530
AoX-time (min)	−0.006	0.001	<0.001
CPB-time (min)	0.004	0.001	<0.001
LVEF	−0.001	0.001	0.003
Baseline creatinine	0.071	0.045	0.116
Transfusion receiver	0.181	0.029	<0.001
Norepinephrine	0.092	0.033	0.006
Apo E4	−0.050	0.032	0.113

Notes: Observed R² = 0.108, statistical power >99%. Observed R² = 0.107, statistical power >99%. Observed R² = 0.108, statistical power >99%. AoX time, aortic cross clamp time; CPB time, cardiopulmonary bypass time; LVEF, left ventricular ejection fraction.

Table 6. Linear regression analysis for postoperative creatinine increase: TNF-α-308 G > A.

	Regression coefficient	Standard error	p
a: TNF AA.
(Constant)	0.046	0.090	0.612
AoX-time	−0.004	0.001	<0.001
CPB-time (min)	0.004	0.001	<0.001
LVEF	0.003	0.001	0.004
Baseline creatinine	0.072	0.045	0.110
Transfusion receiver	0.180	0.029	<0.001
Norepinephrine	0.091	0.033	0.007
TNF 308 AA	−0.034	0.062	0.583
b: TNF GA
(Constant)	0.033	0.090	0.716
AoX-time	−0.004	0.001	<0.001
CPB-time (min)	0.004	0.001	<0.001
LVEF	0.003	0.001	0.004
Baseline creatinine	0.072	0.045	0.112
Transfusion receiver	0.180	0.029	<0.001
Norepinephrine	0.090	0.033	0.007
TNF 308 GA	0.040	0.031	0.208
c: TNF GG
(Constant)	0.046	0.092	0.497
AoX-time	−0.004	0.001	<0.001
CPB-time (min)	0.004	0.001	<0.001
LVEF	−0.003	0.001	0.004
Baseline creatinine	0.071	0.045	0.117
Transfusion receiver	0.181	0.029	<0.001
Norepinephrine	0.090	0.033	0.007
TNF 308 GG	−0.027	0.030	0.357

Notes: Observed R² = 0.107, statistical power >99%. Observed R² = 0.108, statistical power >99%. Observed R² = 0.107, statistical power >99%. AoX time, aortic cross clamp time; CPB time, cardiopulmonary bypass time; LVEF, left ventricular ejection fraction.