Key result
The ACE gene D allele carrier-state was associated with severe atherosclerosis, present in 97.4% of patients with ≥4 vessel stenoses vs 74.4% with 1-3 vessel disease (OR 13.05; 95% CI 1.81-100.00).
Why the study?
Is the ACE gene D allele associated with increased severity of atherosclerosis in patients with premature coronary artery disease?
Cohort (n=172)
Is the ACE gene D allele associated with increased severity of atherosclerosis in patients with premature coronary artery disease?
Effect estimate: OR 13.05 (95% CI 1.81-100.00)
Absolute Event Rate: 97.4% vs 74.4%
p-value: p=0.0017
The ACE gene D allele is associated with more severe and numerous atherosclerotic lesions in patients with premature coronary artery disease.
BACKGROUND: Angiotensin II is produced primarily by angiotensin I-converting enzyme (ACE) within atherosclerotic lesions and ACE level in plaques correlates with the severity of vessel wall damage. Therefore, we investigated the possible association of ACE gene insertion/deletion (I/D) polymorphism and the severity of atherosclerosis, estimated on the basis of the number of coronary stenoses and critical arterial occlusions observed during coronary angiography. METHODS: The study cohort included 172 patients with angiographically confirmed premature coronary artery disease. The ACE gene I/D polymorphism was genotyped using a PCR method. RESULTS: The frequencies of DD genotype, D allele carrier-state (DD+ID genotypes) and the D allele increased with the number of stenoses in coronary vessels. D allele carriers (DD+ID genotypes) were more frequent in the subgroup of patients with stenoses in at least four coronary vessels than in other patients including subjects with one-, two- and three-vessel disease (97.4% vs. 74.4%, OR=13.05, 95% CI: 1.81-100.00, chi2=9.84, p=0.0017). Furthermore, the D allele was significantly more frequent in patients with critical arterial occlusions (>90%) than in subjects without critical stenoses (61.1% vs. 49.3%, chi2=9.84, p=0.023). CONCLUSIONS: The ACE I/D polymorphism influences individual differences in severity of coronary artery disease and the D allele promotes generation of numerous and critical atherosclerotic lesions.
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Niemiec et al. (2008) conducted a cohort in Premature coronary artery disease (n=172). ACE gene D allele carrier-state vs. Non-carriers was evaluated on Stenoses in at least four coronary vessels (OR 13.05, 95% CI 1.81-100.00, p=0.0017). The ACE gene D allele carrier-state was associated with severe atherosclerosis, present in 97.4% of patients with ≥4 vessel stenoses vs 74.4% with 1-3 vessel disease (OR 13.05; 95% CI 1.81-100.00).
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