From Division of Cardiovascular Medicine, Kumamoto Kinoh Hospital, Kumamoto Aging Research Institute, Kumamoto, Japan (Y.M., E.H., S.M., M.S., H.Y.); Department of Cardiology, Nagoya University, Graduate School of Medicine, Nagoya, Japan (S.M., T.M.); School of Pharmaceutical Sciences, Mukogawa Women's University, Koshien, Nishinomiya, Japan (K.K., M.H.); Division of Cardiovascular Medicine, Nara City Hospital, Nara, Japan (Y.M.); Nakayama Cardiovascular Clinic, Amakusa, Japan (M.N.); and Division of Cardiology, Department of Internal Medicine, Jikei University School of Medicine, Tokyo, Japan (M.Y.).
Circulation. 2015 May 12;131(19):1665-73. doi: 10.1161/CIRCULATIONAHA.114.013120. Epub 2015 Mar 10.
Coronary spastic angina (CSA) is a common disease among East Asians, including Japanese. The prevalence of alcohol flushing syndrome associated with deficient activity of the variant aldehyde dehydrogenase 2 (ALDH22) genotype is prevalent among East Asians. We examined whether CSA is associated with the ALDH22 genotype in Japanese.
The study subjects consisted of 202 patients in whom intracoronary injection of acetylcholine was performed by angiography on suspicion of CSA (119 men and 83 women; mean age, 66.2±11.4 years). They were divided into CSA (112 patients) and control groups (90 patients). ALDH2 genotyping was performed by the direct application of the TaqMan polymerase chain reaction system on dried whole blood. Clinical and laboratory data were examined using conventional methods. The frequencies of male sex, ALDH22 genotype carriers, alcohol flushing syndrome, tobacco smoking, and the plasma level of uric acid were higher (P<0.001, P<0.001, P<0.001, P<0.001, and P=0.007, respectively) and the plasma high-density lipoprotein cholesterol levels were lower (P<0.001) in the CSA group than in the control group. The multivariable logistic regression analysis revealed that ALDH22 genotype and smoking were significantly associated with CSA (P<0.001 and P=0.024, respectively).
East Asian variant ALDH2*2 genotypes and, hence, deficient ALDH2 activity were associated with CSA in Japanese. These data support further investigation of treatment targeting aldehydes for CSA.
冠状动脉痉挛性心绞痛（CSA）是东亚人群（包括日本人）中的一种常见疾病。与变异型乙醛脱氢酶 2（ALDH22）基因型活性不足相关的酒精性潮红综合征在东亚人群中很常见。我们研究了 CSA 是否与日本人的 ALDH22 基因型有关。
本研究共纳入 202 例经血管造影怀疑 CSA 的患者（119 例男性，83 例女性；平均年龄 66.2±11.4 岁）。他们分为 CSA 组（112 例）和对照组（90 例）。通过 TaqMan 聚合酶链反应系统直接应用于干血全血进行 ALDH2 基因分型。使用常规方法检查临床和实验室数据。CSA 组男性比例、ALDH22 基因型携带者、酒精性潮红综合征、吸烟和血尿酸水平较高（P<0.001，P<0.001，P<0.001，P<0.001，P=0.007），而血浆高密度脂蛋白胆固醇水平较低（P<0.001）。多变量逻辑回归分析显示，ALDH22 基因型和吸烟与 CSA 显著相关（P<0.001 和 P=0.024）。
东亚变异型 ALDH2*2 基因型和由此导致的 ALDH2 活性不足与日本人的 CSA 有关。这些数据支持进一步研究针对 CSA 的醛类治疗。
