Key result
ACE I/D polymorphism linked to ~29% greater cardiomyopathy risk.
Why the study?
Due to inconsistent findings across studies, the role of renin-angiotensin system gene polymorphisms in cardiomyopathy risk remained unclear.
Do gene polymorphisms in the renin-angiotensin system (ACE I/D, AGT M235T, AGTR1 A1166C) increase the risk of cardiomyopathy?
Meta-Analysis (n=9,644)
Do gene polymorphisms in the renin-angiotensin system (ACE I/D, AGT M235T, AGTR1 A1166C) increase the risk of cardiomyopathy?
ACE I/D gene polymorphisms are associated with an increased risk of cardiomyopathy, whereas AGT M235T and AGTR1 A1166C polymorphisms show limited or model-specific associations.
ACE I/D polymorphism may increase cardiomyopathy susceptibility; leaves open clinical utility of genotyping.
Due to the inconsistent findings from various studies, the role of gene polymorphisms in the renin-angiotensin system in influencing the development of cardiomyopathy remains unclear. In this study, we conducted a systematic review and meta-analysis to summarize the findings regarding the impact of angiotensin converting enzyme (ACE) I/D, angiotensinogen (AGT) M235T, and angiotensin II Type 1 receptor (AGTR1) A1166C gene polymorphisms in patients with cardiomyopathy. We performed a comprehensive search of several electronic databases, including PubMed, Embase, the Cochrane Library, and Web of Science, covering articles published from the time of database creation to April 17, 2023. Studies on the assessment of genetic polymorphisms in genes related to the renin-angiotensin system in relation to cardiomyopathy were included. The primary outcome was cardiomyopathy. Risk of bias was assessed using the Newcastle-Ottawa Scale scale. The meta-analysis includes 19 studies with 4,052 cases and 5,592 controls. The ACE I/D polymorphisms were found to be associated with cardiomyopathy (allelic model D vs I: OR = 1.29, 95CI% = 1.08-1.52; dominant model DD+ID vs II: OR = 1.43, 95CI% = 1.01-2.02; recessive model DD vs ID+II: OR = 0.79, 95CI% = 0.64-0.98). AGT M235T polymorphism and cardiomyopathy were not significantly correlated (allelic model T vs M: OR = 1.26, 95CI% = 0.96-1.66; dominant model TT+MT vs MM: OR = 1.30, 95CI% = 0.98-1.73; recessive model TT vs MT+MM: OR = 0.63, 95CI% = 0.37-1.07). AGTR1 polymorphism and cardiomyopathy were not significantly associated under allelic model A vs C (OR = 0.69, 95CI% = 0.46-1.03) and recessive model AA vs CA+CC (OR = 0.89, 95CI% = 0.34-2.30), but under the dominant model AA+CA vs CC (OR = 0.51, 95CI% = 0.38-0.68). The current meta-analysis reveals that polymorphisms in ACE I/D may be a genetic risk factor for cardiomyopathy. There is an association between AGTR1 gene polymorphisms and risk of cardiomyopathy under the specific model.
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Jia et al. (2024) conducted a meta-analysis in Cardiomyopathy (n=9,644). ACE I/D, AGT M235T, and AGTR1 A1166C gene polymorphisms vs. Non-carriers or alternative genotypes (controls) was evaluated on Cardiomyopathy (OR 1.29, 95% CI 1.08-1.52). The ACE I/D polymorphism was significantly associated with an increased risk of cardiomyopathy (allelic model D vs I: OR 1.29), whereas AGT M235T and AGTR1 A1166C were not significantly correlated.
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