Therapeutics and Clinical Risk Management (Jul 2018)

Predisposition of functional genetic variants of A-kinase anchoring protein 10 toward acquired repolarization disorders in high-risk vascular surgery patients

  • Biernawska J,
  • Solek-Pastuszka J,
  • Kazimierczak A,
  • Safranow K,
  • Kaczmarczyk M,
  • Zegan-Baranska M,
  • Zukowski M,
  • Kotfis K

Journal volume & issue
Vol. Volume 14
pp. 1315 – 1322

Abstract

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Jowita Biernawska,1 Joanna Solek-Pastuszka,1 Arkadiusz Kazimierczak,2 Krzysztof Safranow,3 Mariusz Kaczmarczyk,4 Malgorzata Zegan-Baranska,5 Maciej Zukowski,5 Katarzyna Kotfis5 1Department of Anesthesiology and Intensive Therapy, Pomeranian Medical University, Szczecin, Poland; 2Department of Angiology and Vascular Surgery, Pomeranian Medical University, Szczecin, Poland; 3Department of Biochemistry and Medical Chemistry, Pomeranian Medical University, Szczecin, Poland; 4Department of Clinical and Molecular Biochemistry, Pomeranian Medical University, Szczecin, Poland; 5Department of Anesthesiology, Intensive Therapy and Acute Intoxications, Pomeranian Medical University, Szczecin, Poland Purpose: We aimed at assessing the predisposition of A-kinase anchoring protein 10 (AKAP10) polymorphism toward acquired repolarization disorders in high-risk vascular surgery patients. Patients and methods: One hundred adult patients (age =44–85 years), scheduled for an elective high-risk “open” vascular surgery procedure, were recruited. The electrocardiogram Holter monitor was used to assess repolarization stability from the beginning of the operation up to 24 hours afterward. The AKAP10 gene rs203462 polymorphism and cardiac complications were analyzed. Results: Repolarization disturbances defined as QT interval duration corrected for heart rate (QTc) interval prolongation >500 ms and QTc interval dispersion >65 ms were recorded in 46 patients. A model of multivariate logistic regression showed that only the presence of allele G of the AKAP10 polymorphism was an independent risk factor for repolarization disturbances in the perioperative period (odds ratio =14.35; 95% CI =4.65–44.23; p<0.0001). Conclusion: When the acquired QTc interval prolongation or QTc dispersion is associated with AKAP10 polymorphism, it may remain clinically silent. Keywords: AKAP10, repolarization, vascular surgery, QTc, Holter

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