title: Association between angiotensin-converting enzyme insertion/deletion gene polymorphism and atrial fibrillation: a meta-analysis.
abstract: OBJECTIVE
  Recent observations have raised concerns regarding the activation of the renin-angiotensin system and the development of atrial fibrillation (AF). Some initial studies indicated an association between an angiotensin-converting enzyme insertion/deletion (ACE I/D) polymorphism and AF, however, the results have been inconsistent. Our aim was to perform a meta-analysis of relevant studies to assess the validity of this association.
  
  
  RESULTS
  PubMed, Cochrane clinical trials database, and EMBASE were searched through July 2009, and a manual search was also performed. Of the 68 initially identified studies, 18 case-control studies with 7577 patients were finally analysed. No statistically significant associations were found between the ACE I/D polymorphism and AF risk in the genetic additive model and dominant model, whereas a significant association was observed in the recessive model. A significant heterogeneity between individual studies was evident in all three models. Subgroup analyses showed a strong association between the ACE I/D polymorphism and hypertensive AF without significant heterogeneity.
  
  
  CONCLUSIONS
  Our meta-analysis suggests that there is insufficient evidence to demonstrate an association between ACE I/D polymorphism and AF risk. However, there seems to be a significant association between ACE I/D gene polymorphic variation and AF in patients with hypertension. Additional studies are warranted to further explore this association in ethnically diverse populations and varied cardiovascular substrates.
authors.affiliation: Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin 300211, People's Republic of China.
authors.forename: Tong
authors.initials: T
authors.lastname: Liu
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Korantzopoulos
authors.forename: Gang
authors.initials: G
authors.lastname: Xu
authors.forename: Michael
authors.initials: M
authors.lastname: Shehata
authors.forename: Dong
authors.initials: D
authors.lastname: Li
authors.forename: Xunzhang
authors.initials: X
authors.lastname: Wang
authors.forename: Guangping
authors.initials: G
authors.lastname: Li
mesh_terms: D000328:Adult; D000368:Aged; D001281:Atrial Fibrillation / Q000453:epidemiology / Q000235:genetics* / Q000503:physiopathology; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D054643:INDEL Mutation / Q000235:genetics*; D008297:Male; D008875:Middle Aged; D007703:Peptidyl-Dipeptidase A / Q000235:genetics*; D011110:Polymorphism, Genetic / Q000235:genetics; D012084:Renin-Angiotensin System / Q000502:physiology; D012307:Risk Factors
chemical_list: D007703:Peptidyl-Dipeptidase A