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Insertion/deletion polymorphism in the angiotensin-converting enzyme gene and risk of and prognosis after myocardial infarction.
| Content Provider | Semantic Scholar |
|---|---|
| Author | O'Toole, Laurence Martin, David Rai, Harishchandra Fletcher, Sally Lodwick, David Channer, Kevin C. |
| Copyright Year | 1996 |
| Abstract | OBJECTIVES We sought to prospectively investigate whether genetic variation at the angiotensin-converting enzyme gene locus defined by an insertion (I)/deletion (D) polymorphism influences the risk of myocardial infarction or prognosis after infarction, or both. BACKGROUND It has been suggested that the deletion allele of the angiotensin-converting enzyme gene, and specifically the DD genotype, may increase the risk of myocardial infarction, although previous studies have produced conflicting reports. No studies have yet examined the effect of I/D polymorphism on survival after infarction. METHODS Angiotensin-converting enzyme genotypes in 684 patients with myocardial infarction recruited at the time of the acute event through coronary care units in two centers were compared with those of 537 control subjects recruited from the base populations. All patients were followed up to assess the impact of the angiotensin-converting enzyme genotype on prognosis. RESULTS We found no difference (p = 0.89) in the genotype distribution between patients and control subjects (patients DD 31%, ID 47%, II 22%; control subjects DD 30%, ID 48%, II 22%). The odds ratio for myocardial infarction for DD compared with II/ID genotype adjusted for age, gender and center was 1.16 (95% confidence interval [CI] 0.82 to 1.65, p = 0.44). The study had 90% power to detect a 1.5-fold increase in risk of myocardial infarction associated with the DD genotype. For one center, data were available for other risk factors (hypertension, diabetes, angina, previous myocardial infarction, smoking, body mass index, total and high density lipoprotein cholesterol) in both patients and control subjects. In a stepwise logistic regression analysis the odds ratio for DD versus ID/II genotypes remained nonsignificant (1.44, 95% CI 0.84 to 2.46, p = 0.20) for these subjects. Over a median follow-up period of 15 months (range 3 to 22), 155 patients (22.7%) died. There was no difference in mortality between subjects with the DD genotype and those with ID/II genotypes. (21.8% vs. 23.1%, p = 0.25). Likewise, there was no difference in the distribution of survival times in the two groups (p = 0.62). The study had 70% power to detect a 1.5-fold increase in mortality during follow-up associated with the DD genotype. CONCLUSIONS We conclude that in the groups studied, genetic variation at the angiotensin-converting enzyme gene locus defined by I/D polymorphism does not significantly influence either the risk of or the short- to medium-term prognosis after myocardial infarction. |
| File Format | PDF HTM / HTML |
| Alternate Webpage(s) | https://core.ac.uk/download/pdf/82594703.pdf |
| PubMed reference number | 8800107v1 |
| Volume Number | 28 |
| Issue Number | 2 |
| Journal | Journal of the American College of Cardiology |
| Language | English |
| Access Restriction | Open |
| Subject Keyword | Angina Pectoris Angiotensin-Converting Enzyme Inhibitors Angiotensins Body mass index Cessation of life Confidence Intervals Coronary Care Units Deletion Mutation Diabetes Mellitus Follow-Up Report Forecast of outcome Genotype Hereditary Diseases High Density Lipoprotein Cholesterol Hypertensive disease Insertion Mutation Keratosis Follicularis Lipoproteins Myocardial Infarction Odds Ratio Patients Peptidyl-Dipeptidase A Smoke |
| Content Type | Text |
| Resource Type | Article |
