Why the study?
Is the ACE gene D allele associated with an increased risk of coronary restenosis after PCI compared to the I allele?
Is the ACE gene D allele associated with an increased risk of coronary restenosis after PCI compared to the I allele?
The ACE gene D allele is significantly associated with an increased risk of coronary restenosis following percutaneous coronary intervention across different ethnicities and age groups.
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ACE I/D polymorphism link to restenosis remains inconclusive; leaves open need for larger prospective validation before any clinical use.
OBJECTIVE: Previous case-control studies on the relationship between the angiotensin-converting enzyme (ACE) gene insertion/deletion (I/D) polymorphisms and coronary restenosis did not reach the same conclusion. In the present study, we aimed to further evaluate the relationship between the ACE gene I/D polymorphisms and coronary restenosis, after percutaneous coronary intervention (PCI). METHODS: By searching PubMed, EMBase, the Chinese Biomedical Literature Database and Wanfang database, we selected 16 case-control studies related to ACE gene I/D polymorphism and coronary restenosis after PCI. To test for heterogeneity in each study, we utilized the Q-test and I(2) test. To merge the odds ratio (OR) and 95% CI, we utilized the random effects model during the analyses. RESULTS: The present study included 4693 subjects: 1241 patients with coronary restenosis and 3452 without coronary restenosis. By meta-analysis, we found there was significant association of ACE gene I/D polymorphism with coronary restenosis (D allele versus I allele: OR = 1.92; 95% CI (1.40-2.43); p < 0.001). A subgroup analysis, by stratification according to ethnicity, also showed that this association was found not only in the Caucasian population ((D allele versus I allele: OR = 1.94; 95% CI (1.38-2.80); p < 0.001)), but also in the Asian population ((D allele versus I allele: OR = 1.83; 95% CI (1.05-3.20); p = 0.03)). After stratification according to age, we found that the D allele carriers have a higher risk for development of coronary restenosis in subjects < 60 years old (OR = 2.13; 95% CI: 1.40-3.24; p = 0.0004); while in the subjects ⩾ 60 years old, the association was present with bordering significance (OR = 1.48; 95%CI: 0.98-2.25; p = 0.06). CONCLUSIONS: The present study suggested that the ACE gene I/D polymorphism was associated with coronary restenosis, regardless of age and ethnicity.
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Miao et al. (2015) studied this question.
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