title: Insertion/deletion polymorphism of the angiotensin-converting enzyme considerably changes postoperative outcome.
abstract: OBJECTIVE
  To evaluate the influence of insertion/deletion (ID) polymorphism of the angiotensin-converting enzyme (ACE) gene on clinical outcome of cardiac valve surgery.
  
  
  METHODS
  Prospective, blinded observational study.
  
  
  METHODS
  Operating room and intensive care unit (ICU) of a university hospital.
  
  
  METHODS
  110 adult patients requiring elective cardiac valve surgery requiring cardiopulmonary bypass.
  
  
  METHODS
  Patients' preoperative data (age, gender, body weight, New York Heart Association score, medication, biochemical data, and comorbid disorders), anesthetic management (blood pressure, heart rate, blood loss and transfusion, and cardiorespiratory complications and their treatment), and postoperative outcome (life-threatening complications, nosocomial infections, reintubation/reoperation, death, and duration of ICU stay and hospitalization) were recorded. ACE ID was detected by gel electrophoresis following conventional polymerase chain reaction. Patients were divided into two groups postoperatively; groups with II and non-II (ID and DD) genotypes, and group differences were analyzed.
  
  
  RESULTS
  Distribution of ACE ID in II, ID, and DD genotypes was 29%, 59%, and 12%, respectively. The non-II group had significantly greater postoperative blood loss and transfusion (P < 0.05), more common postoperative infections, and longer ICU stay duration than the II group (P < 0.01).
  
  
  CONCLUSIONS
  ACE ID polymorphism is associated with a higher incidence of postoperative complications, including postoperative infections, in patients undergoing cardiac valve surgery.
authors.affiliation: Department of Anesthesiology, Tokyo Women's Medical University, Tokyo Women's Medical University. 8-1 Kawada-cho, Shinjuku, Tokyo 162-8666, Japan. nakazawa.twmu@gmail.com
authors.forename: Keisuke
authors.initials: K
authors.lastname: Nakazawa
authors.forename: Naoki
authors.initials: N
authors.lastname: Kotani
authors.forename: Kaoru
authors.initials: K
authors.lastname: Goto
authors.forename: Minoru
authors.initials: M
authors.lastname: Nomura
authors.forename: Makoto
authors.initials: M
authors.lastname: Ozaki
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical; D002315:Cardiopulmonary Bypass / Q000379:methods; D017558:Elective Surgical Procedures / Q000379:methods; D005260:Female; D017353:Gene Deletion; D005838:Genotype; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006785:Hospitals, University; D006801:Humans; D054643:INDEL Mutation; D015994:Incidence; D007362:Intensive Care Units; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D016254:Mutagenesis, Insertional; D007703:Peptidyl-Dipeptidase A / Q000235:genetics*; D016133:Polymerase Chain Reaction; D011110:Polymorphism, Genetic; D011183:Postoperative Complications / Q000453:epidemiology / Q000235:genetics*; D011446:Prospective Studies; D016037:Single-Blind Method; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000235:genetics; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D007703:Peptidyl-Dipeptidase A