TY - JOUR
T1 - Association of angiotensin I-converting enzyme gene polymorphism with myocardial ischemia and patency of infarct-related artery in patients with acute myocardial infarction
AU - Dakik, Habib A.
AU - Mahmarian, John J.
AU - Verani, Mario S.
AU - Farmer, John A.
AU - Zhao, Guiling
AU - Marian, Ali J.
N1 - Funding Information:
This work was supported in part by grants from the American Heart Association, Texas Affiliate (95R-1191), Austin, Texas; Established Investigator Award (9640133N), from the American Heart Association, National Center, Dallas, Texas; The Methodist Hospital Foundation, Houston, Texas; and the Caroline Wiess Law Fund for Research in Molecular Medicine, Baylor College of Medicine, Houston, Texas.
Copyright:
Copyright 2007 Elsevier B.V., All rights reserved.
PY - 1997/6
Y1 - 1997/6
N2 - Objectives. We determined the influence of angiotensin I-converting enzyme (ACE) insertion (I)/deletion (D) polymorphism on the extent of myocardial ischemia in patients with acute myocardial infarction. Background. The I/D polymorphism, which in part controls plasma and tissue expression of ACE, has been implicated in predisposition to myocardial infarction and ventricular remodeling. Methods. I/D genotyping, predischarge adenosine- thallium-201 perfusion tomography and radionuclide angiography were performed in 113 patients (72 men, 41 women) with a diagnosis of acute myocardial infarction. A subgroup of 96 patients also underwent coronary angiography. Results. Genotypes DD, ID and II were present in 27, 56 and 30 patients, respectively. There was no significant difference in the baseline characteristics of patients, total creatine kinase, peak MB fraction, Killip class, mean ejection fraction or the number of diseased vessels in patients with the DD, ID or II genotype. However, the size of the total and the reversible perfusion defects was greater in those with DD than in those with ID or II genotype (total defect size [mean ± SD] 33.7 ± 22.5%, 29.5 ± 19.2% and 22.2 ±16.0%, respectively [p = 0.0221; reversible defect size 18.0 ± 16.0%, 12.1 ± 11.6% and 8.2 ± 7.8%, respectively [p = 0.006]). Occlusion of the infarct-related artery was also more common in patients with DD genotype (odds ratio 3.9, 95% confidence interval 1.4 to 11.0). Multivariate analysis showed that the I/D genotype was an independent predictor of perfusion defect size and potency of the infarct-related artery (p = 0.001). Conclusions. DD genotype was associated with a larger ischemic defect and occlusion of the infarct-related artery. Patients with DD genotype, having a larger ischemic defect, are expected to be at a greater risk for subsequent cardiovascular events.
AB - Objectives. We determined the influence of angiotensin I-converting enzyme (ACE) insertion (I)/deletion (D) polymorphism on the extent of myocardial ischemia in patients with acute myocardial infarction. Background. The I/D polymorphism, which in part controls plasma and tissue expression of ACE, has been implicated in predisposition to myocardial infarction and ventricular remodeling. Methods. I/D genotyping, predischarge adenosine- thallium-201 perfusion tomography and radionuclide angiography were performed in 113 patients (72 men, 41 women) with a diagnosis of acute myocardial infarction. A subgroup of 96 patients also underwent coronary angiography. Results. Genotypes DD, ID and II were present in 27, 56 and 30 patients, respectively. There was no significant difference in the baseline characteristics of patients, total creatine kinase, peak MB fraction, Killip class, mean ejection fraction or the number of diseased vessels in patients with the DD, ID or II genotype. However, the size of the total and the reversible perfusion defects was greater in those with DD than in those with ID or II genotype (total defect size [mean ± SD] 33.7 ± 22.5%, 29.5 ± 19.2% and 22.2 ±16.0%, respectively [p = 0.0221; reversible defect size 18.0 ± 16.0%, 12.1 ± 11.6% and 8.2 ± 7.8%, respectively [p = 0.006]). Occlusion of the infarct-related artery was also more common in patients with DD genotype (odds ratio 3.9, 95% confidence interval 1.4 to 11.0). Multivariate analysis showed that the I/D genotype was an independent predictor of perfusion defect size and potency of the infarct-related artery (p = 0.001). Conclusions. DD genotype was associated with a larger ischemic defect and occlusion of the infarct-related artery. Patients with DD genotype, having a larger ischemic defect, are expected to be at a greater risk for subsequent cardiovascular events.
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U2 - 10.1016/S0735-1097(97)00086-7
DO - 10.1016/S0735-1097(97)00086-7
M3 - Article
C2 - 9180106
AN - SCOPUS:0030955439
VL - 29
SP - 1468
EP - 1473
JO - Journal of the American College of Cardiology.
JF - Journal of the American College of Cardiology.
SN - 0735-1097
IS - 7
ER -