INSERTION DELETION (I D) POLYMORPHISM AT THE LOCUS FOR ANGIOTENSIN-I-CONVERTING ENZYME AND MYOCARDIAL-INFARCTION/

Male (n = 185) and female (n = 49) survivors of myocardial infarction (MI) below 56 and 61 years of age, respectively, were compared to 366 controls with respect to distribution of genotypes in an insertion/del etion (ID) polymorphism at the angiotensin 1-converting enzyme (ACE) l ocus. The frequency of the DD genotype (homozygosity for the deletion allele) was significantly lower among male patients than controls (22. 7% versus 34.9%, p = 0.011). In a ''low-risk'' group, defined as havin g less than the sex-specific, age-adjusted median values of body mass index (BMI) and apolipoprotein B (apoB), respectively, and absence of treatment with lipid-lowering drugs, the prevalence of the DD genotype was not statistically different between male patients and controls. I n a male ''high-risk'' group (those individuals who had not been defin ed as ''low-risk'' subjects), the prevalence of the DD genotype was 20 .9% in patients and 38.3% in controls (p = 0.002). In women. no signif icant differences in genotype frequencies between patients and control s were found in the whole sample or in any subgroup. These results app ear to be at variance with data reported recently by Cambien et al. (1 992). The difference may be due to chance, undetected selection biases , different gene-environment interactions between Norway and France or Ireland, or to preferential loss of DD individuals in our male ''high -risk'' group.