Angiotensin I-converting enzyme gene polymorphism, coronary artery diseaseand myocardial infarction - An angiographically controlled study

Objectives We investigated the association between insertion/deletion polym orphism of the angiotensin I-converting enzyme (ACE) gene, the presence and extent of coronary artery disease, and myocardial infarction. Background The D allele of the ACE gene has been associated with coronary a rtery disease and myocardial infarction, but this association has been chal lenged in epidemiological studies. Methods Nine hundred and sixty-nine men and 341 women undergoing coronary a ngiography were studied. The ACE genotypes were assessed by polymerase chai n reaction from genomic deoxyribonucleic acid, homozygosity for the D allel e was controlled using an insertion-specific primer. Coronary artery diseas e was defined by angiographic criteria, the extent of coronary artery disea se by the number of coronary arteries with greater than or equal to 50% lum en narrowing. Results The ACE genotypes did not differ in terms of age, sex, body mass in dex, blood pressure, plasma lipids or lipoproteins. We found no association between the ACE genotypes and coronary artery disease (odds ratio, 95% con fidence interval in DD genotypes for coronary artery disease in men 0.97, 0 .70-1.36; in women 1.56, 0.95-2.57), extent of coronary artery disease (men 1.17, 0.85-1.61; women 1.24, 0.65-2.34), or myocardial infarction among th e patients with coronary artery disease (men 1.07, 0.78-1.48; women 0.95, 0 .50-1.76). The ACE genotype was not associated with coronary artery disease or myocardial infarction in hypertensives (n=771; odds ratio for coronary artery disease 0.93, 0.65-1.34; odds ratio for myocardial infarction 0.94, 0.66-1.33), or in patients less than or equal to 60 years (n=649; odds rati o for coronary artery disease 1.05, 0.72-1.52; odds ratio for myocardial in farction 0.96, 0.63-1.47). Conclusion ACE insertion/deletion gene polymorphism is associated neither w ith the prevalence nor the extent of coronary artery disease, nor with myoc ardial infarction in this relatively large sample of Caucasian men and wome n. Genotyping for ACE insertion/deletion polymorphism is not useful in asse ssing the individual risk of coronary artery disease or myocardial infarcti on.