心房細動患者におけるALDH2遺伝子多型と冠動脈疾患との相関

The objectives of this study is to investigate the correlation between genotype polymorphism of aldehyde dehydrogenase 2 (ALDH2) and coronary artery disease (CAD) in atrial fibrillation patients.

From November 2020 to December 2021, 80 patients with atrial fibrillation at a medical center in Chengdu were divided into two groups: CAD group (n = 25) and non-CAD group (n = 55). The genotype composition ratio of ALDH2 (mutant-type/wild-type), blood biochemical indexes, the proportion of the history of lipid-lowering drugs and time of taking lipid-lowering drug were compared between the two groups.

The CAD group showed significantly lower levels of total cholesterol and low-density lipoprotein cholesterol (LDL-C) compared with the non-CAD group (p < 0.05), and the proportion and time of taking lipid-lowering drugs in CAD group were significantly increased (p < 0.05). The frequency of the ALDH2 genotype (mutant-type/wild-type) in the CAD group was notably elevated compared with that in the non-CAD group (p < 0.05). In patients with atrial fibrillation, the risk of CAD in patients with ALDH2 mutant genotype (GA + AA) was 5.849 times that of ALDH2 wild-type genotype (GG) (95%CI = 1.437-23.795, p < 0.05). The area under ROC curve of ALDH2 mutant genotype (GA + AA) was 0.624 (SE = 0.069, 95%CI : 0.488-0.759). In patients with ALDH2 wild-type (GG), the levels of total cholesterol and LDL-C in CAD group were significantly lower than those in non-CAD group (p < 0.05). However, in patients with ALDH2 mutation genotype (GA + AA), the proportion of history of lipid-lowering drugs in CAD group was significantly higher than that in non-CAD group (p < 0.05).

The polymorphism of ALDH2 gene is a high risk factor for CAD in patients with atrial fibrillation. The ALDH2 mutation genotype (GA + AA) may reduce the lipid-lowering efficacy of statins.