ASSOCIATION BETWEEN MYOCARDIAL-INFARCTION AND ANGIOTENSIN-CONVERTING ENZYME GENE POLYMORPHISM IN YOUNG-PATIENTS

BACKGROUND: Different studies have shown a relationship between an ins ertion-deletion polymorphism of the angiotensin converting enzyme (ACE ) gene and the risk of ischemic heart disease, although there are no d ata on this association in the Spanish population. MATERIAL AND METHOD : We have studied three groups of patients: I, healthy volunteers (n = 56, mean age 36.20 +/- 4.20 years); II, patients having presented an acute myocardial infarction (MI) less than or equal to 50 years (n = 5 9, mean age 42.30 +/- 5.30 years), and III, patients with MI over the age of 50 years (n = 60, mean age 66.36 +/- 9.47 years), In all patien ts the genotype ACE gen was determined by an assay based on the polyme rase chain reaction. RESULTS: The distribution of the ACE genotype bet ween the three groups were not significative. Comparing the ratio of D D/II-DI in groups II and III, there were 26/33 versus 15/45 (p = 0.028 64), There was no difference in the smoking, hypercholesterolemia and hypertension between groups II and III; there were only differences in familial history of ischemic heart disease; diabetes mellitus was mor e prevalent in the III group. A multivariate analysis showed that smok ing familial history of ichemic heart disease, hypercholesterolemia an d DD genotype were more prevalent in young patients (OR 3.92, 2.85, 2. 36 and 1.77), whereas diabetes mellitus was more prevalent in the grou p of older patients. There were no differences in the ACE genotype wit h respect to infarct location or gender. CONCLUSIONS: In our populatio n DD ACE genotype is associated with MI in young patients, although sm oking, family history and hypercholesterolemia show a more powerful as sociation.