ANGIOTENSIN-CONVERTING ENZYME GENE POLYMORPHISM IS NOT ASSOCIATED WITH CORONARY ATHEROSCLEROSIS AND MYOCARDIAL-INFARCTION IN A SAMPLE OF ITALIAN PATIENTS

Background The deletion (D) allele of the angiotensin-converting enzym e (ACE) gene has been proposed as a genetic marker of the risk of isch aemic heart disease. However, the relationships between ACE genotypes, the development of coronary atherosclerosis and the occurrence of maj or coronary events are still controversial. Methods To investigate whe ther the ACE I/D (insertion/deletion) polymorphism predicts the risk o f coronary stenosis and myocardial infarction (MI), ACE genotypes were determined in 394 consecutive patients who underwent coronary angiogr aphy. The presence of coronary artery disease (CAD) (defined by > 50% stenosis) was detected in 236 patients (CAD+); 85 of these individuals had a history of MI. Patients with coronary stenosis < 10% (n = 158) served as controls (CAD-). ACE genotypes were determined by agarose ge l sizing after polymerase chain reaction (PCR) amplification. Results The distribution of ACE genotypes in CAD+ patients was not significant ly different from that in CAD- patients (chi(2) = 2.63, P < 0.27). Aft er controlling for other coronary risk factors, no significant increas e in risk of CAD or MI was found to be associated with the D allele, r egardless of whether the D allele was assumed to have a dominant, a co dominant or a recessive effect. Similar results were observed in CADpatients at lower risk because of low body mass index and apolipoprote in B concentrations. Smoking, apolipoprotein B and history of hyperten sion were found to be independent predictors of CAD and MI. Conclusion Our study did not provide evidence of a significant association betwe en ACE genotypes and the development of coronary atherosclerosis. It a lso failed to support a role of ACE I/D polymorphism in favouring the conversion of coronary stenosis to MI.