ArticleThe American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry2019
The Association Between C-Reactive Protein and Postoperative Delirium Differs by Catechol-O-Methyltransferase Genotype.
Article in The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 2 of them syntheses that pooled it.
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Who cites it
10 citing papers in PubMed, 2 syntheses or guidelines pooled it, 17 citations in OpenAlex.
- Predisposing and Precipitating Factors Associated With Delirium: A Systematic Review.JAMA network open · 2023Pooled it
- The complex interaction of genetics and delirium: a systematic review and meta-analysis.European archives of psychiatry and clinical neuroscience · 2021Pooled it
- Comparison of Remimazolam and Propofol on Postoperative Delirium in Elderly Patients Undergoing Radical Resection of Colon Cancer: A Single-Center Prospective Randomized Controlled Study.Medical science monitor : international medical journal of experimental and clinical research · 2024Trial
- Linear association between high-sensitivity C-reactive protein and postoperative delirium after general anesthesia: a cross-sectional study.Frontiers in neurology · 2025Article
- Automated machine learning-based model predicts postoperative delirium using readily extractable perioperative collected electronic data.CNS neuroscience & therapeutics · 2022Observational
- Preoperative homocysteine modifies the association between postoperative C-reactive protein and postoperative delirium.Frontiers in aging neuroscience · 2022Article
- An Exploratory Analysis of the Association Between Catechol-O-Methyltransferase and Response to a Randomized Open-Label Placebo Treatment for Cancer-Related Fatigue.Frontiers in psychiatry · 2021Article
- Systems Level Analysis and Identification of Pathways and Key Genes Associated with Delirium.Genes · 2020Article
- Apolipoprotein E genotype and the association between C-reactive protein and postoperative delirium: Importance of gene-protein interactions.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2020Article
- Systems pharmacogenomics - gene, disease, drug and placebo interactions: a case study in COMT.Pharmacogenomics · 2019Article
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10 authors at 5 institutions in 1 country.
Funding
Abstract
objectiveCatechol-O-methyltransferase (COMT), a key enzyme in degrading catecholamines associated with the stress response, may influence susceptibility to delirium. Individuals with the COMT (rs4680) Val/Val genotype (designated "warriors") withstand the onset of neuropsychiatric disorders and cognitive decline, whereas individuals with Met/Met and Val/Met genotypes ("nonwarriors") are more susceptible to these conditions. We evaluated whether COMT genotype modifies the established association between acute phase reactant (stress marker) C-reactive protein (CRP) and postoperative delirium.
methodsThis was a prospective cohort study conducted at two academic medical centers. The study involved 547 patients aged 70 or older undergoing major noncardiac surgery. We collected blood, extracted DNA, and performed COMT genotyping using allele-specific polymerase chain reaction assays, considering warriors versus nonwarriors. High plasma CRP, measured on postoperative day 2 using enzyme-linked immunosorbent assay, was defined by the highest sample-based quartile (≥234.12 mg/L). Delirium was determined using the Confusion Assessment Method, augmented by a validated chart review. We used generalized linear models adjusted for age, sex, surgery type, and race/ethnicity, stratified by COMT genotype, to determine whether the association between CRP and delirium differed by COMT.
resultsPrevalence of COMT warriors was 26%, and postoperative delirium occurred in 23%. Among COMT warriors, high CRP was not associated with delirium (relative risk [RR] 1.0, 95% confidence interval [CI] 0.4-2.6). In contrast, among nonwarriors, we found the expected relationship of high CRP and delirium (RR 1.5, 95% CI 1.1-2.2).
conclusionCOMT warriors may be protected against the increased risk of delirium associated with high CRP on postoperative day 2. With further confirmation, COMT genotype may help target interventions for delirium prevention in the vulnerable nonwarrior group.
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