Insertion/deletion polymorphism of the angiotensin converting enzyme gene and acute myocardial infarction. A case - control study in Venezuela

Abstract

Objective: Detection of the ACE I/D polymorphism genotype and the association with essential hypertension and acute myocardial infarction (AMI) in the Venezuelan population.Methods: Samples from 200 patients with AMI and 200 control subjects were analyzed for genotyping ACE I/D polymorphism. A subset of 82 samples underwent the determination of angiotensin II levels (pg/ml). Results: The frequency for the heterozygous ID was 52.50% vs 44.50% and 26.50% vs 36.00% for DD homozygous individuals for AMI and control groups respectively. The D allele frequency was very similar for both populations (0.535 for AMI vs 0.583 for control subjects). The OR for AMI in carriers for the D allele was 0.91 (95% CI: 0.54-1.53, p>0.05). We found a 2.66 fold increased risk between individuals belonging to the AMI group (OR= 2.66, 95% CI: 1.33-5.31, p<0.05) and an 8.46 fold increased risk for AMI in hypertensive individuals (OR=8.46, 95% CI: 5.24-1368; p<0.05). Finally, we detected a statistically significant difference in angiotensin II levels between individuals with DD and II genotypes (6.59±2.93 pg/ml DD genotype vs 4.26±1.40 pg/ml II genotype, p<0.05).Conclusions: We did not find the ACE genotype as a marker for AMI; but we found at statistically significant increased risk between hypertensive individuals carrying the D allele belonging to the AMI group. The lack of direct association between D risk allele and the AMI could be due to the well known multifactorial nature of this pathology.