POLYMORPHISM OF THE APOLIPOPROTEIN-E AND ANGIOTENSIN-I-CONVERTING-ENZYME GENES IN JAPANESE PATIENTS WITH MYOCARDIAL-INFARCTION

Objective To investigate the genetic contribution for myocardial infar ction. Methods We investigated common polymorphisms of apolipoprotein E gene and angiotensin converting enzyme (ACE) gene in Japanese popula tion. Subjects were 422 healthy people and 254 patients with myocardia l infarction. We evaluated the 287 base pair (bp) insertion (I)/deleti on (D) polymorphism in intron 18 of the ACE gene and a polymorphism in the apolipoprotein E gene by using the polymerase chain reaction. Res ults The ACE genotype prevalences for II, ID, and DD were 36.2, 46.1, and 17.7%, respectively, among the myocardial infarction patients. The prevalence of the D allele of the ACE gene among the myocardial infar ction patients (0.593) exceeded that among the healthy controls (0.407 ). The prevalences of the epsilon 2, epsilon 3, and epsilon 4 alleles of the apolipoprotein E genotype among healthy controls were 0.024, 0. 882, and 0.094, and those among survivors of myocardial infarction wer e 0.024, 0.834, and 0.142, respectively. Myocardial infarction patient s had an excessive prevalence of the kapolipoprotein E epsilon 4 allel e (P < 0.05). Multiple regression analysis demonstrated that the indep endent risk factors for developing myocardial infarction were age, DD genotype of ACE gene, and apolipoprotein E epsilon 4 allele. Stenotic coronary vessels in myocardial infarction patients did not differ sign ificantly among the patients with various ACE and apolipoprotein E gen otypes in the present study. Conclusions Among the Japanese, apolipopr otein E epsilon 4 carriers and subjects with ACE DD genotype are at an increased risk of myocardial infarction. Coronary Artery Dis 9:329-33 4 (C) 1998 Lippincott Williams & Wilkins.