title: The association of ACE I/D gene polymorphism with severe carotid atherosclerosis in patients undergoing carotid endarterectomy.
abstract: BACKGROUND
  The ACE I/D polymorphism was mostly investigated in association with intima-media thickness, rarely with severe atherosclerotic phenotype.
  
  
  METHODS
  We investigated the association of I/D polymorphism with severe carotid atherosclerosis (CA) (stenosis > 70%) in asymptomatic and symptomatic patients undergoing carotid endarterectomy. The 504 patients subjected to endarterectomy and 492 healthy controls from a population in Serbia were investigated as a case-control study.
  
  
  RESULTS
  The univariate logistic regression analysis revealed ACE DD as a significant risk factor for severe CA (odds ratio [OR] = 1.3, 95% confidence interval [CI] 1.0-1.7, p = 0.04). After adjustment for the common risk factors (age, hypertension, smoking, and HDL) ACE was no longer significant. However, we found a significant independent influence of DD genotype on plaque presence in a normotensive subgroup of patients (OR 1.8, CI 1.2-3.0, p = 0.01, corrected for multiple testing). In symptomatic patients D allele carriers were significantly more frequent compared with asymptomatic patients (OR 1.6 CI 1.0-2.6, p = 0.05).
  
  
  CONCLUSIONS
  Our data suggests that ACE I/D is not an independent risk factor for severe CA. On the other hand, a significant independent genetic influence of ACE I/D appeared in normotensive and symptomatic patients with severe CA. This should be considered in further research toward resolving the complex genetic background of severe CA phenotype.
authors: VINčA Institute of Nuclear Sciences, Laboratory for Radiobiology and Molecular Genetics, University of Belgrade, Belgrade, Serbia.
authors: Ana
authors: A
authors: Kolaković
authors: Maja
authors: M
authors: Zivković
authors: Djordje
authors: D
authors: Radak
authors: Tamara
authors: T
authors: Djurić
authors: Igor
authors: I
authors: Koncar
authors: Lazar
authors: L
authors: Davidović
authors: Dragan
authors: D
authors: Dincić
authors: Dragan
authors: D
authors: Alavantić
authors: Aleksandra
authors: A
authors: Stanković
mesh_terms: D050197:Atherosclerosis / Q000150:complications / Q000235:genetics; D002340:Carotid Artery Diseases / Q000235:genetics* / Q000601:surgery*; D016022:Case-Control Studies; D016894:Endarterectomy, Carotid; D005260:Female; D005787:Gene Frequency / Q000235:genetics; D056726:Genetic Association Studies; D020022:Genetic Predisposition to Disease; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000235:genetics; D054643:INDEL Mutation / Q000235:genetics*; D008297:Male; D008875:Middle Aged; D007703:Peptidyl-Dipeptidase A / Q000235:genetics*; D011110:Polymorphism, Genetic; D012307:Risk Factors
chemical_list: C488034:ACE protein, human; D007703:Peptidyl-Dipeptidase A