Searching for a better assessment of the individual coronary risk profile - The role of angiotensin-converting enzyme, angiotensin II type 1 receptorand angiotensinogen gene polymorphisms

Background Polymorphisms within renin angiotensin system genes have been in vestigated as risk factors for coronary artery disease in different populat ions with contradicting results. The aim of this study was to investigate t he genotype distribution and the allele frequencies of ACE, AT1R and AGT ge ne polymorphisms as coronary artery disease factors and their synergistic e ffects on coronary risk in an Italian population. Methods and Results In this study ACE, AT1R and AGT gene polymorphisms were investigated in 205 consecutive coronary artery disease patients and in 20 9 controls. These polymorphisms were analysed by polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP). The ACE D and AG T 235T allele, but not AT1R C allele, frequency was statistically significa nt in patients. An association between coronary artery disease and ACE DD, AT1R CC and AGT TT genotype, was found by univariate analysis (OR 2.06 P=0. 0007, OR 2.49 P=0.009, OR 1.87 P=0.019, respectively). At multivariate anal ysis ACE DD and AT1R CC genotype (OR 1.81 P=0.011, OR 2.61 P=0.011, respect ively) remained associated with coronary heart disease. Subjects carrying t he ACE DD genotype and AT1R C allele showed a stronger association with myo cardial infarction (OR=4.02, P=0.0001). Conclusion Our report indicates the increased risk of coronary artery disea se in the presence of ACE DD and AT1R CC genotypes independent of other ris k factors, in Italian patients. The present study stresses the relevance of screening for genetic risk factors. (Eur Heart J 2000; 21: 633-638) (C) 20 00 The European Society of Cardiology.