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Background  Elevated baseline C-reactive protein (CRP) levels are associated with increased risk for developing cardiovascular disease. Several  CRP  gene variants have been associated with altered baseline CRP levels in ambulatory populations. However, the influence of  CRP  gene variants on CRP levels during inflammatory states, such as surgery, is largely unexplored. We describe the association between candidate  CRP  gene variants and postoperative plasma CRP levels in patients undergoing primary, elective coronary artery bypass graft (CABG) surgery with cardiopulmonary bypass (CPB).    Methods  Using a multicenter candidate gene association study design, we examined the association between seventeen candidate  CRP  single nucleotide polymorphisms (SNPs) and inferred haplotypes, and altered postoperative CRP levels in 604 patients undergoing CABG surgery with CPB. Perioperative CRP levels were measured immediately prior to surgery, post-CPB and on postoperative days (POD) 1–4.    Results  CRP levels were significantly elevated at all postoperative time points when compared with preoperative levels (P < 0.0001). After adjusting for clinical covariates, the minor allele of the synonymous coding SNP, rs1800947 was associated with lower peak postoperative CRP levels ( P  = 2.4 × 10 -4 ) and lower CRP levels across all postoperative time points ( P  = 4.8 × 10 -5 ). rs1800947 remained highly significant after Bonferroni adjustment for multiple comparisons.    Conclusion  We identified a  CRP  gene SNP associated with lower postoperative CRP levels in patients undergoing CABG surgery with CPB. Further investigation is needed to clarify the significance of this association between  CRP  gene variants and the acute-phase rise in postoperative CRP levels with regard to the risk of adverse postoperative outcomes.

C-Reactive protein gene variants are associated with postoperative C-reactive protein levels after coronary artery bypass surgery