title: Angiotensin converting enzyme DD genotype is associated with acute coronary syndrome severity and sudden cardiac death in Taiwan: a case-control emergency room study.
abstract: BACKGROUND
  Angiotensin converting enzyme (ACE) gene insertion/deletion (I/D) polymorphisms have been associated with acute coronary syndrome (ACS); however, several controversial results have also been found in different studied populations. This hospital-based, emergency room, case-control study in Taiwan retrospectively investigated 111 ACS patients, and 195 non-coronary subjects as a control group, to study the effects of ACE I/D polymorphism in the most urgent ACS patients. ACE I/D polymorphisms were determined by polymerase chain reaction-based assays and their associations with ACS risk, severity, and sudden cardiac death were determined.
  
  
  RESULTS
  The ACE DD genotype was associated with ACS incidence. The DD genotype was associated with a significant 4-fold higher risk of ACS in multivariate analysis (odds ratio (OR) = 4.295; 95% confidence interval (CI): 1.436-12.851, p = 0.009), and a 3.35-fold higher risk of acute myocardial infarction. DD genotype carriers also had more than 3-fold higher risks of stenosis in all the three coronary arteries, left anterior descending artery infarction, and anterior wall infarction. In addition, the DD genotype was also associated with a higher risk of sudden cardiac death (OR = 6.484, 95% CI: 1.036-40.598, p = 0.046).
  
  
  CONCLUSIONS
  This study demonstrated that the ACE DD genotype is an independent risk factor for ACS, and in particular, for acute myocardial infarction. In addition, the ACE DD genotype is also associated with greater ACS severity and a higher risk of sudden cardiac death. ACE genotyping is recommended for patients with a history of ACS, and more intensive preventive care is suggested for patients with the DD genotype.
authors.affiliation: Department of Pathology, and Graduate Institute of Pathology and Parasitology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Ying-Hsin
authors.initials: YH
authors.lastname: Chen
authors.forename: Jui-Ming
authors.initials: JM
authors.lastname: Liu
authors.forename: Ren-Jun
authors.initials: RJ
authors.lastname: Hsu
authors.forename: Sheng-Chuan
authors.initials: SC
authors.lastname: Hu
authors.forename: Horng-Jyh
authors.initials: HJ
authors.lastname: Harn
authors.forename: Shee-Ping
authors.initials: SP
authors.lastname: Chen
authors.forename: Jing-Ren
authors.initials: JR
authors.lastname: Jeng
authors.forename: Chieh-Lin
authors.initials: CL
authors.lastname: Wu
authors.forename: Jar-Yi
authors.initials: JY
authors.lastname: Ho
authors.forename: Cheng-Ping
authors.initials: CP
authors.lastname: Yu
mesh_terms: D054058:Acute Coronary Syndrome / Q000209:etiology / Q000235:genetics* / Q000401:mortality; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D016757:Death, Sudden, Cardiac / Q000453:epidemiology* / Q000209:etiology; D004636:Emergency Service, Hospital; D005260:Female; D005838:Genotype; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology / Q000235:genetics* / Q000401:mortality; D007703:Peptidyl-Dipeptidase A / Q000235:genetics*; D011110:Polymorphism, Genetic; D012307:Risk Factors; D013624:Taiwan
chemical_list: D007703:Peptidyl-Dipeptidase A