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October 24, 2005Current Controlled Trials in Cardiovascular MedicineOpen Access

Does the Angiotensin-converting enzyme (ACE) gene insertion/deletion polymorphism modify the response to ACE inhibitor therapy? – A systematic review

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Why the study?

Does the ACE gene insertion/deletion polymorphism modify the response to ACE inhibitor therapy in patients with cardiovascular and/or renal disease?

Population

Patients treated with ACE inhibitors for cardiovascular and/or renal disease from 11 randomized…

Comparison

ACE inhibitor therapy vs Placebo

Design

Systematic_review

Authors

MSMadlaina ScharplatzHorten KommuneMPMilo A. PuhanDartmouth CollegeJSJohann SteurerKantonsspital Winterthur

Discussion

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Implication

Preliminary observations suggest a better response to ACE inhibitors among Caucasian DD carriers compared to II carriers, but insufficient data precludes definitive conclusions.

Structured PICO

Does the ACE gene insertion/deletion polymorphism modify the response to ACE inhibitor therapy in patients with cardiovascular and/or renal disease?

P
Population
Patients treated with ACE inhibitors for cardiovascular and/or renal disease from 11 randomized, placebo-controlled trials (only 4 provided sufficient data).
I
Intervention
ACE inhibitor therapy (assessing effect modification by ACE gene insertion/deletion polymorphism)
C
Comparator
Placebo
O
Outcome
Any outcome (including blood pressure, proteinuria, glomerular filtration rate, ACE activity and progression to end-stage renal failure)

Preliminary observations suggest a better response to ACE inhibitors among Caucasian DD carriers compared to II carriers, but insufficient data precludes definitive conclusions.

Limitations

  • Lack of sufficient genetic data from the reviewed studies (only 4 of 11 provided sufficient data)
  • Heterogeneity in ethnicity, clinical domains and outcomes precluding pooling

Cite This Study

Scharplatz et al. (2005) studied this question.

synapsesocial.com/papers/6a713855f44fa9f079deff44https://doi.org/10.1186/1468-6708-6-16
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1The deletion/insertion polymorphism of the angiotensin converting enzyme gene and cardiovascular-renal risk1997 · 391 citations
  2. 2Effect of angiotensin-converting enzyme (ACE) gene polymorphism on progression of renal disease and the influence of ACE inhibition in IDDM patients: findings from the EUCLID Randomized Controlled Trial. EURODIAB Controlled Trial of Lisinopril in IDDM.1998 · 161 citations
  3. 3Angiotensin-Converting Enzyme Inhibitors and Progression of Nondiabetic Renal Disease2001 · 1,115 citations
  4. 4Randomized placebo-controlled trial of perindopril in normotensive, normoalbuminuric patients with type 1 diabetes mellitus2001 · 60 citations
  5. 5Effects of Enalapril on Mortality in Severe Congestive Heart Failure1987 · 5,137 citations