Tokunaga S, Tsuji H, Nishiue T, Yamada K, Miyasaka Y, Saitou D, Iwasaka T
Cardiovascular Center, Kansai Medical University, Moriguchi-City, Osaka, Japan.
Acta Cardiol. 2001 Dec;56(6):351-5. doi: 10.2143/AC.56.6.2005698.
The angiotensin-converting enzyme (ACE) gene insertion/deletion (I/D) polymorphism has been associated with different serum ACE concentrations and cardiac ACE activity. We assessed whether the ACE gene I/D polymorphism influenced cardiac mortality in Japanese patients with acute myocardial infarction.
The ACE gene I/D polymorphism was determined in 441 consecutive patients with a first myocardial infarction. There were 69 patients (16%) with the DD genotype, 194 patients (44%) with the ID genotype, and 178 patients (40%) with the II genotype. During a mean follow-up of 9.4 months, there were 49 cardiac deaths (DD, n = 4; ID, n = 26; II, n = 19). The DD genotype was significantly associated with a lower mortality than the other genotypes (p = 0.0363) by Cox regression analysis adjusted for age, sex, site of myocardial infarction, Killip functional class, reperfusion therapy during acute phase, ACE inhibitor use, and beta-blocker use.
In a selected cohort of Japanese patients, the DD genotype was associated with a significantly lower cardiac mortality after a first myocardial infarction.
血管紧张素转换酶（ACE）基因插入/缺失（I/D）多态性与不同的血清ACE浓度及心脏ACE活性相关。我们评估了ACE基因I/D多态性是否影响日本急性心肌梗死患者的心脏死亡率。
对441例首次发生心肌梗死的连续患者进行ACE基因I/D多态性检测。其中69例（16%）为DD基因型，194例（44%）为ID基因型，178例（40%）为II基因型。在平均9.4个月的随访期间，有49例心脏死亡（DD基因型4例，ID基因型26例，II基因型19例）。经年龄、性别、心肌梗死部位、Killip心功能分级、急性期再灌注治疗、ACE抑制剂使用及β受体阻滞剂使用校正后的Cox回归分析显示，DD基因型的死亡率显著低于其他基因型（p = 0.0363）。
在一组选定的日本患者中，DD基因型与首次心肌梗死后显著较低的心脏死亡率相关。
