ACE D/I polymorphism and incidence of post-PTCA restenosis - A prospective, angiography-based evaluation

Early restenosis is the major complication of percutaneous transluminal cor onary angioplasty (PTCA), occurring in approximate to 30% of all initially successful procedures, The D/I polymorphism of the ACE gene, which has vari ably been reported to represent a risk factor for manifestations of ischemi c heart disease, has recently been implicated in the pathophysiology of res tenosis after PTCA by some investigators but not by others. All studies con ducted thus far involved relatively small sample sizes. We investigated the possible association of ACE D/I genotype and post-PTCA restenosis in a lar ge, prospective sample of patients followed by quantitative coronary angiog raphy. The ACE D/I gene polymorphism was characterized in a cohort of 779 p atients, of whom 342 (cases) had developed restenosis (as defined by >50% l oss of lumen compared with immediate postprocedure results) at repeat quant itative coronary angiography at 6 months after PTCA. Allele frequencies for the ACE D and I alleles were 0.58 and 0.42 in cases and 0.58 and 0.42 in c ontrol subjects. All observed genotype frequencies were in Hardy-Weinberg e quilibrium, There was no evidence for an association between genotype and r estenosis or degree of lumen loss. The data from this largest study of its kind conducted so far provide no evidence for an association of the ACE D/I allelic polymorphism with incidence of restenosis after PTCA. On the basis of the power of this study, we conclude that in a general population, the ACE D/I polymorphism is not a useful marker to assess risk of post-PTCA res tenosis.