GENE POLYMORPHISM BUT NOT CATALYTIC ACTIVITY OF ANGIOTENSIN I-CONVERTING ENZYME IS ASSOCIATED WITH CORONARY-ARTERY DISEASE AND MYOCARDIAL-INFARCTION IN LOW-RISK PATIENTS

Background An insertion/deletion (I/D) polymorphism of the angiotensin I-converting enzyme (ACE) gene has been postulated to be associated w ith an increased risk of coronary artery disease (CAD) and myocardial infarction (MI). Methods and Results In the present study, the effects of I/D gene polymorphism acid of ACE activity on CAD and MI were inve stigated in 920 individuals who underwent coronary angiography for dia gnostic purposes. In the total population and in all CAD and MI groups , a strong association was observed between the gene polymorphism and ACE activities; DD genotypes had approximately twofold higher ACE acti vities than II genotypes. Although classic risk and protective factors of CAD and MI were identified, associations of ACE genotype and of AC E activity to CAD and MI were not detected in the total population. Am ong subjects defined to be at lower risk of MI by low body mass index and low cigarette consumption, however, an association of the DD genot ype with MI was found. Exclusion of individuals with triglyceride leve ls >140 mg/dL and cholesterol levels >180 mg/dL revealed an associatio n of the DD genotype with CAD. An association of the ACE activity with CAD or MI could not be demonstrated in any of the low-risk population s. Conclusions Increased ACE activity obviously is not a risk factor o f CAD or MI. The importance of the deletion polymorphism for the devel opment of CAD and MI may be restricted to individuals without classic risk factors.