Association of inflammatory gene polymorphisms with mechanical heart valve reoperation

BACKGROUND Various complications lead to reoperation in patients who undergo prosthetic valve replacement where inflammatory process could be involved. The goals of this study were to identify risk factors that correlate with reoperation in patients with prosthetic heart valves and to investigate the relationship between reoperation and inflammatory gene polymorphisms. RESULTS The study included 228 patients from the EwhA-Severance Treatment Group of Warfarin. Single nucleotide polymorphisms of c-reactive protein (CRP), interferon-gamma, interleukin 1 beta, interleukin 6, interleukin 10, transforming growth factor beta 1, and tumor necrosis factor genes were genotyped by means of SNaPshot and TaqMan assays. Thirty-nine patients (17.1 %) underwent more than one heart valve operation. A threefold increased risk for heart valve reoperation was evident in homozygous variant-type (TT) carriers as compared with ancestral allele carriers of CRP rs1205. Logistic regression analysis revealed that CRP rs1205 (OR 2.68, 95 % CI 1.22-5.90, p = 0.014), valve position (mitral valve OR 2.80, 95 % CI 1.01-7.80, p = 0.048; tricuspid valve OR 9.24, 95 % CI 2.46-34.70, p = 0.001; reference: aortic valve) and time after first operation (OR 1.13, 95 % CI 1.06-1.20, p < 0.001) affected the risk of reoperation. CONCLUSIONS Inflammatory gene polymorphisms could be a possible marker of risk for reoperation in patients with prosthetic heart valve surgery.