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The Insertion/Deletion Polymorphism of the Angiotensin-Converting Enzyme Gene and the Risk for Restenosis After PTCA

Völzke1, Hertwig, Rettig

  • 1Clinic of Internal Medicine B, Ernst Moritz Arndt University, Greifswald, Germany

The International Journal of Angiology : Official Publication of the International College of Angiology, Inc
|April 12, 2000
PubMed

Insights

Genetic factors, specifically the angiotensin I-converting enzyme (ACE) I/D genotype, were investigated as a risk factor for restenosis after percutaneous transluminal coronary angioplasty (PTCA). The ACE DD genotype was not found to be an independent predictor of restenosis.

Area of Science:

  • Cardiology
  • Genetics
  • Interventional Cardiology

Background:

  • Restenosis limits the long-term success of percutaneous transluminal coronary angioplasty (PTCA).
  • Mechanisms underlying restenosis are not fully understood, suggesting potential roles for genetic factors.
  • The angiotensin I-converting enzyme (ACE) I/D genotype is a candidate genetic marker for cardiovascular diseases.

Purpose of the Study:

  • To investigate the angiotensin I-converting enzyme (ACE) I/D genotype as a potential risk factor for restenosis after successful PTCA.
  • To evaluate the association between the ACE I/D genotype and clinical and angiographic predictors of restenosis.

Main Methods:

  • A cohort of 511 patients undergoing successful PTCA with follow-up angiography were genotyped for the ACE I/D polymorphism.
  • Clinical and angiographic data, including degree of stenosis and lesion severity, were collected.
  • Restenosis was defined as >50% progression of stenosis at follow-up angiography.

Main Results:

  • One hundred sixty patients (31.3%) developed restenosis.
  • A higher prevalence of the ACE DD genotype was observed in the restenosis group compared to the no-restenosis group.
  • This association was not statistically significant after adjusting for clinical and angiographic variables. Patients with restenosis had higher pre-PTCA stenosis and lesion severity, and lower post-PTCA residual stenosis.

Conclusions:

  • The angiotensin I-converting enzyme (ACE) DD genotype is not an independent risk factor for restenosis following percutaneous transluminal coronary angioplasty (PTCA).
  • Clinical and angiographic factors remain significant predictors of restenosis after PTCA.

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