Key result
The ACE DD genotype was significantly associated with peripartum cardiomyopathy compared to controls (OR 7.225; 95% CI 1.88-27.6; p=0.0039).
Why the study?
Is the ACE insertion/deletion polymorphism associated with peripartum cardiomyopathy and worse left ventricular performance?
Case-Control (n=115)
No
Is the ACE insertion/deletion polymorphism associated with peripartum cardiomyopathy and worse left ventricular performance?
Odds Ratio: 7.225 (95% CI 1.88–27.6)
Absolute Event Rate: 24.4% vs 4.3%
p-value: p=0.0039
The ACE DD genotype and D allele are significantly more frequent in females with peripartum cardiomyopathy and are associated with worse echocardiographic systolic performance indices.
ACE DD genotype may confer higher peripartum cardiomyopathy risk; hypothesis-generating and requires prospective validation before clinical consideration.
BACKGROUND: The role of polymorphism of Angiotensin converting enzyme (ACE) gene and ACE activity in etiopathogenesis, prognosis, and many other clinical parameters in the various form of the cardiovascular disease has been established to some degree of certainty. The pathophysiology of Peripartum cardiomyopathy (PPCM) remains an area of active research. The main aim of our study was to see pattern of ACE- Insertion/Deletion (I/D) allele in PPCM and its implications on left ventricular performance indices. METHODS: This single-center case-control study included 45 cases and 70 controls. The diagnosis of PPCM was established clinically and echocardiographically. ACE genotyping was done by polymerase chain reaction (PCR) method in all subjects. RESULTS: The II, ID, and DD genotype was present in 16, 18 and 11 of subjects with PPCM and 48, 19 and 3 of controls respectively. The odds ratio for ACE-II genotype in cases vs. controls was 0.253 (95% CI=0.114-0.558; p=0.007), for that of II genotype was 1.93 (95% CI=0.86-4.3; p=0.107) and for DD genotype was 7.225 (95% CI; 1.88-27.6; p=0.0039). Overall frequency of D allele in cases was significantly higher than controls (odds=4.25; 95% CI=2.01-6.7; p=0.0001). Moreover, ejection fraction, left ventricular volume and linear dimensions were worse in patients with DD genotype. CONCLUSION: ACE DD genotype and overall frequency of D allele is significantly higher in patients with PPCM. Also, the presence of DD genotype is associated with worse systolic performance indices measured echocardiographically.
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Yaqoob et al. (2017) conducted a case-control in Peripartum cardiomyopathy (n=115). ACE DD genotype vs. Controls was evaluated on Peripartum cardiomyopathy (OR 7.225, 95% CI 1.88-27.6, p=0.0039). The ACE DD genotype was significantly associated with peripartum cardiomyopathy compared to controls (OR 7.225; 95% CI 1.88-27.6; p=0.0039).
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