Published online before print July 9, 2009, doi: 10.1161/STROKEAHA.109.553339
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(Stroke. 2009;40:2969.)
© 2009 American Heart Association, Inc.
Original Contributions |
P-Selectin 1087G/A Polymorphism Is Associated With Neuropsychological Test Performance in Older Adults With Cardiovascular Disease
From the Department of Psychology (J.G., A.B., M.B.S., L.S.K.), Kent State University, Kent, Ohio; the Department of Psychiatry (J.G., M.B.S.), Summa Health System, Akron, Ohio; the Division of Psychosocial Medicine (K.F.H.), National Jewish Medical and Research Center, Denver, Colo; the Department of Psychiatry and Human Behavior (J.M., J.M., L.H.S., R.A.C.), Brown Medical School, Providence, RI; the Department of Cardiology, Rhode Island Medical Center (A.P.), Providence, RI; the Department of Psychology (R.H.P.), University of Missouri, St Louis, Mo; and Alzheimer’s Disease Center (A.L.J.), Department of Neurology, Boston University School of Medicine, Boston, Mass.
Correspondence to John Gunstad, PhD, 221 Kent Hall, Kent State University, Kent, OH 44242. E-mail jgunstad{at}kent.edu
Background and Purpose— There is growing evidence that the cell adhesion molecule P-selectin (SELP) contributes to the adverse vascular processes that promote cognitive impairment in individuals with cardiovascular disease. Previous research has shown that SELP genotypes moderate circulating levels of P-selectin and that patients undergoing coronary artery bypass graft with the SELP 1087A allele were less likely to show postoperative cognitive decline and more likely to exhibit lower levels of C-reactive protein than noncarriers. Thus, we expected that carriers of the 1087A allele (n=43) would exhibit better cognitive functioning than persons with 2 1087G alleles (n=77) and that C-reactive protein levels would be important for this relationship.
Methods— One hundred twenty older adults with diagnosed cardiovascular disease were recruited from outpatient cardiology clinics. Each participant underwent a comprehensive neuropsychological test battery and a blood draw.
Results— Participants with the SELP 1087A allele performed more poorly on tests of attention (Trail Making Test A: t[116]=3.20, P=0.002), executive function (Trail Making Test B: t[116]=2.89, P=0.005), psychomotor speed (Digit–Symbol Coding: t[117]=2.54, P=0.012), and memory (California Verbal Learning Test Discrimination: t[116]=2.05, P=0.04). There were no significant differences between the SELP genotype groups on demographic/medical variables or C-reactive protein levels.
Conclusions— Contrary to expectations, the present analyses showed that older patients with cardiovascular disease with the SELP 1087A allele performed more poorly on neuropsychological testing. Findings from the present study were counter to previous research with coronary artery bypass graft candidates. Further work using neuroimaging and alternative measures of cardiovascular function is needed to clarify the mechanisms of this association.
Key Words: cognitive function • heart disease • P-selectin
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