(Circulation. 1995;92:296-299.)
© 1995 American Heart Association, Inc.
Articles |
Relation Between the Deletion Polymorphism of the Angiotensin-Converting Enzyme Gene and Late Luminal Narrowing After Coronary Angioplasty
From University and CHRU de Lille (M.H., C.B., E.P.M., J.-M.L., M.E.B., P.A.) and Institut Pasteur de Lille (C.A., N.H., P.A.), Lille, France.
Correspondence to Michel Bertrand, MD, Service de Cardiologie B, Hôpital Cardiologique, Boulevard du Professeur J Leclercq, 59037 Lille, France.
Background The insertion/deletion (I/D) polymorphism of the angiotensin-converting enzyme (ACE) gene has been implicated in the pathogenesis of coronary artery disease. The deletion allele is strongly associated with the level of circulating ACE and is a potent risk factor for myocardial infarction. Recently, the deletion allele was also associated with the occurrence of visually diagnosed restenosis after percutaneous transluminal coronary angioplasty (PTCA) in a selected population of patients with acute myocardial infarction.
Methods and Results We investigated the influence of the ACE I/D polymorphism on the occurrence of restenosis after PTCA with the use of quantitative coronary angiography. ACE I/D genotypes were characterized in 118 consecutive patients who had one-vessel disease and were undergoing systematic angiographic follow-up. Coronary angiograms were analyzed before and after PTCA and at follow-up (7.4±3.0 months). Before PTCA, there were no clinical or angiographic differences among the three groups of genotypes (DD, n=39; ID, n=62; II, n=17). After PTCA, the mean differences in minimal luminal diameter between post-PTCA and pre-PTCA angiograms (acute gain) were identical in the three groups, as was the mean percent residual stenosis. At follow-up angiography, the mean difference in minimal coronary luminal diameter between post-PTCA and follow-up angiograms (late loss) was not significantly different in the three groups of genotypes. The percentage of patients with restenosis defined as a >50% stenosis was identical in the three groups.
Conclusions In this quantitative study, the I/D polymorphism of the ACE gene had no influence on the occurrence of restenosis after coronary angioplasty.
Key Words: angiotensin • enzymes • genes • angioplasty • stenosis
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