Department of Cardiology, The first people's hospital of Wenling, Wenling, Zhejiang, People's Republic of China.
PLoS One. 2013 Sep 30;8(9):e75285. doi: 10.1371/journal.pone.0075285. eCollection 2013.
In the past decade, a number of cohort studies studies have been carried out to investigate the relationship between the insertion/deletion polymorphism of the gene encoding angiotensin-converting enzyme and risk of restenosis after percutaneous transluminal coronary angioplasties in patients. However, these studies have yielded contradictory results. Genetic association studies addressing this issue are frequently hampered by insufficient power. We therefore performed a meta-analysis of the published studies to clarify this inconsistency and to establish a comprehensive picture of the relationship between ACE I/D polymorphism and post-PTCA restenosis risk.
Databases including Pubmed, EMBASE, ISI Web of Science, EBSCO, Cochrane Library databases and CNKI were searched to find relevant studies. Odds ratios (ORs) with 95% confidence intervals (CIs) were used to assess the strength of association. The random-effects model was applied, addressing heterogeneity and publication bias.
A total of 33 cohort studies involving 11,099 subjects were included. In a combined analysis, the OR for post-PTCA restenosis of the ACE DD genotype was 1.61 (95% CI: 1.27-2.04; P<10(-5)). In the subgroup analysis by intervention, significantly increased risks were also found in PTCA-stent and PTCA-balloon for the DD genotype of the polymorphism.
Our meta-analysis showed that the DD genotype of ACE I/D polymorphism was significantly associated with increased risk of restenosis, particularly for PTCA-stent.
在过去的十年中，已经进行了许多队列研究，以研究血管紧张素转换酶基因编码的插入/缺失多态性与经皮腔内冠状动脉成形术后再狭窄风险之间的关系。然而，这些研究产生了相互矛盾的结果。解决这个问题的遗传关联研究经常受到效力不足的阻碍。因此，我们对已发表的研究进行了荟萃分析，以阐明这种不一致，并全面了解 ACE I/D 多态性与经皮腔内冠状动脉成形术后再狭窄风险之间的关系。
检索 Pubmed、EMBASE、ISI Web of Science、EBSCO、Cochrane 图书馆数据库和中国知网（CNKI）等数据库，以查找相关研究。使用优势比（OR）及其 95%置信区间（CI）来评估关联的强度。应用随机效应模型来解决异质性和发表偏倚。
共纳入 33 项队列研究，涉及 11099 名患者。综合分析显示，ACE DD 基因型与经皮腔内冠状动脉成形术后再狭窄的 OR 为 1.61（95%CI：1.27-2.04；P<10(-5)）。按干预方式进行亚组分析，发现该多态性的 DD 基因型在经皮腔内冠状动脉成形术支架和球囊中也显著增加了风险。
我们的荟萃分析表明，ACE I/D 多态性的 DD 基因型与再狭窄风险显著相关，尤其是对于经皮腔内冠状动脉成形术支架。
