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Published on: November 14, 2017
Increased risk for ischaemic events is related to combined RAS polymorphism
P P van Geel1, Y M Pinto, A H Zwinderman
1Department of Cardiology, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, Netherlands. p.p.geel@med.rug.nl
Objective:
To determine whether the angiotensin converting enzyme (ACE) and the angiotensin II type 1 receptor (AT(1)R A1166C) gene polymorphism interact to increase the risk of ischaemic events, and whether this can be explained by the progression of angiographically defined coronary atherosclerosis.
Design:
Prospective defined substudy of the lipid lowering regression trial (REGRESS).
Setting:
University hospital.
Patients:
885 male patients with stable coronary artery disease.
Main Outcome Measures:
Incidence of ischaemic events during a two year follow up; serial quantitative coronary arteriography (mean segment diameter and minimum obstruction diameter) at baseline and after two years.
Results:
Patients who carried both the ACE-DD and AT(1)R-CC genotype had significantly more ischaemic events during the two year follow up than those carrying other genotype combinations (p = 0.035, Mantel-Haenszel test for linear association). There was no association between the two genotypes and mean segment diameter or minimum obstruction diameter at baseline or after two years.
Conclusions:
The suggestion that ACE-DD and AT(1)R-CC genotypes interact to increase the risk of ischaemic events is confirmed. However, this increased risk was not accompanied by increased progression of angiographically defined coronary atherosclerosis.
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