ACE gene ID polymorphism in acute coronary syndrome patients

Abstract

Aim. То investigate the association between ID polymorphism of ACE gene and acute coronary syndrome (ACS) development and progression. Material and metliods. This prospective study analyzed hospital and post-hospital (one-year) outcomes in 376 patients with myocardial infarction (MI) or unstable angina (UA), as well as outcome association with ACE gene ID polymorphism. Results. Q-wave IM risk in ACE gene DD genotype patients was 2,1 and 2,5 times higher than in participants with ID or II genotypes, respectively. On the contrary, UA episodes in these patients were significantly less frequent, being registered in 24,8%, 45,8%, and 52,3% of the subjects with DD, ID, and II genotypes, respectively (df=2; p<0,001). Maximal DD genotype prevalence was observed in individuals with creatine kinase and/or its MB-fraction (CK/MB-CK) positive MI, especially in patients under 65. In CK/MB-CK negative MI, as well as in UA, ID and II genotype patients were more prevalent. ACE gene ID and II genotypes were associated with better outcomes after acute myocardial ischemia episodes, but only in those under 75. In the elderly, fatal event risk increased abruptly, being at least twice as high in II genotype individuals than in DD genotype patients. Conclusion. ACE gene DD genotype is associated with Q-wave MI, especially in younger individuals. ID and II genotypes are protective and associated with better outcomes in patients under 75.

Keywords

• angiotensin-converting enzyme
• gene polymorphism
• acute coronary syndrome
• prognosis