Angiotensin converting enzyme (ACE) insertion/deletion (I/D) polymorphism and circulating ACE levels are not associated with outcome in critically ill septic patients.
BACKGROUND
In critically ill patients independent studies have shown contradictory findings regarding the prognostic significance of the D/D genotype of the I/D angiotensin converting enzyme (ACE) polymorphism. The study aim was to evaluate the effect of both ACE I/D polymorphism and ACE serum levels on the clinical outcomes of critically ill septic patients.


METHODS
This study recruited 186 Caucasian patients with sepsis, severe sepsis or septic shock. Epidemiological, clinical data, co-morbidities and severity scores were recorded. Measurements of serum ACE activity and genotyping for ACE I/D polymorphism were carried out. Primary outcomes were the 28- and the 90-day mortality; secondary outcomes included the number of days without renal or cardiovascular failure and ventilation-free days over the 28-day period following study enrolment.


RESULTS
Neither 28- nor 90-day mortality were associated with ACE I/D polymorphism (p=0.59 and 0.34, respectively) or circulating ACE levels (p=0.17 and 0.25, respectively). Similarly, ACE polymorphism and levels were not related to ventilation-free days (p=0.14 and 0.25, respectively), days without cardiovascular failure (p=0.14 and 0.81, respectively) and days without renal failure (p=0.64 and 0.27, respectively).


CONCLUSIONS
Neither ACE I/D polymorphism nor serum ACE levels seem to be significant prognostic factors of clinical outcomes in septic, critically ill patients.
Laboratory of Haematology and Blood Bank Unit, "Attiko" University Hospital, Medical School, University of Athens, Athens, Greece. atsantes@yahoo.com
Argirios
A
Tsantes
Iraklis
I
Tsangaris
Petros
P
Kopterides
Georgios
G
Nikolopoulos
Eleni
E
Kalamara
Georgios
G
Antonakos
Violetta
V
Kapsimali
Argiri
A
Gialeraki
Ioanna
I
Dimopoulou
Stylianos
S
Orfanos
Kleanthi
K
Dima
Anthi
A
Travlou
Apostolos
A
Armaganidis
D016638:Critical Illness; D005260:Female; D017353:Gene Deletion; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000150:complications; D008297:Male; D008875:Middle Aged; D007703:Peptidyl-Dipeptidase A / Q000097:blood* / Q000235:genetics*; D011110:Polymorphism, Genetic; D018805:Sepsis / Q000097:blood* / Q000150:complications / Q000235:genetics*
D007703:Peptidyl-Dipeptidase A