Angiotensin-converting enzyme and apolipoprotein B polymorphisms in coronary artery disease

The association between angiotensin-converting enzyme (ACE) as well as apol ipoprotein B polymorphisms and dyslipidemia and coronary artery disease (CA D) is controversial. We assessed the distribution of ACE insertion and/or d eletion, apolipoprotein B signal peptide insertion and/or deletion, and apo lipoprotein B Xbal restriction fragment length polymorphisms in 388 nondiab etic patients. We studied 112 patients with angiographically defined asympt omatic CAD or with stable functional classes I and II angina and 139 patien ts with acute myocardial infarction who were age matched to 137 control sub jects. Univariate analysis showed higher prevalence of Xbal X+/X+ genotype in patients with CAD (p = 0.02), ACE and apolipoprotein polymorphisms were not associated with lipid levels and the number of major coronary artery ve ssels with >50% reduction of lumen diameter. Overall, multivariable regress ion disclosed traditional risk factors and elevated levels of apolipoprotei n B for men and reduced levels of apolipoprotein Al for women as independen t variables for CAD. After adjustment for the most important subset of risk factors (age, hypertension, hypercholesterolemia, and smoking), apolipopro tein B Xbal polymorphism was disclosed as an independent variable for CAD. Apolipoprotein B Xbal was also selected as an independent variable for acut e myocardial infarction after adjusting for age, hypertension, hypercholest erolemia, and smoking. Thus, in addition to traditional coronary risk facto rs, apolipoproteins B and Al, and apolipoprotein B Xbal polymorphism could be considered predictors of CAD. (C) 2000 by Excerpta Medica, Inc.