Kamitani A, Rakugi H, Higaki J, Ohishi M, Shi S J, Takami S, Nakata Y, Higashino Y, Fujii K, Mikami H
Department of Geriatric Medicine, Osaka (Japan) University Medical School.
Hypertension. 1995 May;25(5):950-3. doi: 10.1161/01.hyp.25.5.950.
To explore the genes responsible for myocardial infarction and restenosis after percutaneous transluminal coronary angioplasty, we performed association studies of the polymorphisms of the angiotensinogen and angiotensin-converting enzyme (ACE) genes. In the first study, normotensive myocardial infarction patients (n = 103) and control subjects (n = 103), who were matched for established risk factors with the myocardial infarction patients, were randomly selected. The angiotensinogen-TT genotype (T indicates threonine instead of methionine at position 235) was more frequent in the myocardial infarction group than in the control group (P < .05). The ACE-DD genotype (D indicates a deletion polymorphism in intron 16) was also more frequent in the myocardial infarction group (P < .0001). The odds ratio estimated by the combined analysis of the angiotensinogen-TT and ACE-DD genotypes (11.2) was markedly increased compared with that estimated separately from the angiotensinogen-TT (1.75) or ACE-DD (4.43) genotype. In the second study, we investigated 91 consecutive patients with acute myocardial infarction who underwent successful direct angioplasty. Combined analysis showed that the angiotensinogen-TT genotype did not enhance the predictability of myocardial infarction from the ACE-DD genotype. In conclusion, the angiotensinogen-TT genotype is a predictor for myocardial infarction, as well as the ACE-DD genotype, and the combined analysis of the angiotensinogen-TT and ACE-DD genotypes further enhanced the predictability of myocardial infarction in Japanese, suggesting its future clinical usefulness.
为了探究经皮腔内冠状动脉成形术后心肌梗死和再狭窄的相关基因，我们对血管紧张素原和血管紧张素转换酶（ACE）基因的多态性进行了关联研究。在第一项研究中，随机选取了血压正常的心肌梗死患者（n = 103）和对照受试者（n = 103），后者在已确定的风险因素方面与心肌梗死患者相匹配。心肌梗死组中血管紧张素原-TT基因型（T表示第235位的苏氨酸而非甲硫氨酸）的频率高于对照组（P <.05）。ACE-DD基因型（D表示第16内含子的缺失多态性）在心肌梗死组中也更为常见（P <.0001）。与分别根据血管紧张素原-TT基因型（1.75）或ACE-DD基因型（4.43）估算的比值比相比，血管紧张素原-TT和ACE-DD基因型联合分析估算的比值比（11.2）显著升高。在第二项研究中，我们调查了91例接受成功直接血管成形术的急性心肌梗死连续患者。联合分析表明，血管紧张素原-TT基因型并未增强根据ACE-DD基因型预测心肌梗死的能力。总之，血管紧张素原-TT基因型与ACE-DD基因型一样，都是心肌梗死的预测指标，并且血管紧张素原-TT和ACE-DD基因型的联合分析进一步提高了日本人心肌梗死的预测能力，表明其未来具有临床应用价值。
