title: Association of ACE insertion or deletion polymorphisms with the risk of coronary restenosis after percutaneous coronary intervention: A meta-analysis.
abstract: OBJECTIVE
  Previous case-control studies on the relationship between the angiotensin-converting enzyme (ACE) gene insertion/deletion (I/D) polymorphisms and coronary restenosis did not reach the same conclusion. In the present study, we aimed to further evaluate the relationship between the ACE gene I/D polymorphisms and coronary restenosis, after percutaneous coronary intervention (PCI).
  
  
  METHODS
  By searching PubMed, EMBase, the Chinese Biomedical Literature Database and Wanfang database, we selected 16 case-control studies related to ACE gene I/D polymorphism and coronary restenosis after PCI. To test for heterogeneity in each study, we utilized the Q-test and I(2) test. To merge the odds ratio (OR) and 95% CI, we utilized the random effects model during the analyses.
  
  
  RESULTS
  The present study included 4693 subjects: 1241 patients with coronary restenosis and 3452 without coronary restenosis. By meta-analysis, we found there was significant association of ACE gene I/D polymorphism with coronary restenosis (D allele versus I allele: OR = 1.92; 95% CI (1.40-2.43); p < 0.001). A subgroup analysis, by stratification according to ethnicity, also showed that this association was found not only in the Caucasian population ((D allele versus I allele: OR = 1.94; 95% CI (1.38-2.80); p < 0.001)), but also in the Asian population ((D allele versus I allele: OR = 1.83; 95% CI (1.05-3.20); p = 0.03)). After stratification according to age, we found that the D allele carriers have a higher risk for development of coronary restenosis in subjects < 60 years old (OR = 2.13; 95% CI: 1.40-3.24; p = 0.0004); while in the subjects ⩾ 60 years old, the association was present with bordering significance (OR = 1.48; 95%CI: 0.98-2.25; p = 0.06).
  
  
  CONCLUSIONS
  The present study suggested that the ACE gene I/D polymorphism was associated with coronary restenosis, regardless of age and ethnicity.
authors.affiliation: Department of Cardiology, Jinshan Hospital, Fudan University, Shanghai, Peoples' Republic of China.
authors.forename: Hai-Wei
authors.initials: HW
authors.lastname: Miao
authors.affiliation: Department of Cardiology, Jinshan Hospital, Fudan University, Shanghai, Peoples' Republic of China gonghigh@163.com.
authors.forename: Hui
authors.initials: H
authors.lastname: Gong
mesh_terms: D023903:Coronary Restenosis / Q000201:enzymology* / Q000235:genetics*; D005006:Ethnicity / Q000235:genetics; D056726:Genetic Association Studies; D020022:Genetic Predisposition to Disease; D006801:Humans; D054643:INDEL Mutation / Q000235:genetics*; D007703:Peptidyl-Dipeptidase A / Q000235:genetics*; D062645:Percutaneous Coronary Intervention; D011110:Polymorphism, Genetic; D017594:Publication Bias; D012307:Risk Factors
chemical_list: C488034:ACE protein, human; D007703:Peptidyl-Dipeptidase A
keywords: Angiotensin-converting enzyme; coronary artery disease; coronary restenosis; gene polymorphism; meta-analysis; percutaneous coronary intervention; restenosis