title: Variant Aldehyde Dehydrogenase 2 (ALDH2*2) Is a Risk Factor for Coronary Spasm and ST-Segment Elevation Myocardial Infarction.
abstract: Mitochondrial aldehyde dehydrogenase 2 (ALDH2) plays a key role in removing toxic aldehydes. Deficient variant ALDH2*2 genotype is prevalent in up to 40% of the East Asians and reported to be associated with acute myocardial infarction (AMI). To elucidate the mechanisms underlying the association of ALDH2*2 with AMI, we compared the clinical features of AMI patients with ALDH2*2 to those with wild-type ALDH2*1/*1.
  
  
  
  The study subjects consisted of 202 Japanese patients with acute ST-segment elevation myocardial infarction (STEMI) (156 men and 46 women; mean age, 67.3±12.0) who underwent primary percutaneous coronary intervention (PCI). In 85 patients, provocation test for coronary spasm was also done 6 month post-PCI. ALDH2 genotyping was performed by direct application of the TaqMan polymerase chain system. Of the 202 patients, 103 (51.0%) were carriers of ALDH2*2 and 99 (49.0%) those of ALDH2*1/*1. There were no differences in clinical features between ALDH2*2 and ALDH2*1/*1 carrier groups except higher frequencies of coronary spasm and alcohol flush syndrome (AFS) (88.6% vs 56.1%; P=0.001 and 94.3% vs 17.6%; P<0.001), less-frequent alcohol habit (14.6% vs 51.5%; P<0.001), and higher peak plasma creatine phophokinase levels (2224 vs 1617 mg/dL; P=0.002) in the ALDH2*2 than the ALDH2*1/*1 carrier group.
  
  
  
  ALDH2*2 is prevalent (51.0%) among Japanese STEMI patients, and those with ALDH2*2 had higher frequencies of coronary spasm and AFS and more-severe myocardial injury compared to those with ALDH2*1/*1.
authors.affiliation: Division of Cardiovascular Medicine, Kumamoto Kinoh Hospital, Kumamoto Aging Research Institute, Kumamoto, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Mizuno
authors.affiliation: Department of Cardiovascular Medicine, Faculty of Life Science, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.
authors.forename: Seiji
authors.initials: S
authors.lastname: Hokimoto
authors.affiliation: Division of Cardiovascular Medicine, Kumamoto Kinoh Hospital, Kumamoto Aging Research Institute, Kumamoto, Japan.
authors.forename: Eisaku
authors.initials: E
authors.lastname: Harada
authors.affiliation: School of Pharmaceutical Sciences, Mukogawa Women's University, Koshien Nishinomiya, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Kinoshita
authors.affiliation: Division of Pharmacology and Therapeutics, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto, Japan.
authors.forename: Kazuko
authors.initials: K
authors.lastname: Nakagawa
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Michihiro
authors.initials: M
authors.lastname: Yoshimura
authors.affiliation: Department of Cardiovascular Medicine, Faculty of Life Science, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.
authors.forename: Hisao
authors.initials: H
authors.lastname: Ogawa
authors.affiliation: Division of Cardiovascular Medicine, Kumamoto Kinoh Hospital, Kumamoto Aging Research Institute, Kumamoto, Japan yasue@juryo.or.jp.
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Yasue
mesh_terms: D000368:Aged; D000071396:Aldehyde Dehydrogenase, Mitochondrial / Q000235:genetics*; D044466:Asian People; D002492:Central Nervous System Depressants / Q000009:adverse effects; D003329:Coronary Vasospasm / Q000235:genetics*; D003402:Creatine Kinase / Q000097:blood; D000431:Ethanol / Q000009:adverse effects; D005260:Female; D005483:Flushing / Q000139:chemically induced / Q000235:genetics; D020022:Genetic Predisposition to Disease; D014644:Genetic Variation; D005838:Genotype; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention; D012307:Risk Factors; D000072657:ST Elevation Myocardial Infarction / Q000097:blood / Q000235:genetics* / Q000601:surgery; D012720:Severity of Illness Index; D020107:Troponin T / Q000097:blood
chemical_list: D002492:Central Nervous System Depressants; D020107:Troponin T; D000431:Ethanol; C096127:ALDH2 protein, human; D000071396:Aldehyde Dehydrogenase, Mitochondrial; D003402:Creatine Kinase
keywords: acute myocardial infarction; alcohol flushing syndrome; aldehyde dehydrogenase 2; coronary spasm; coronary spastic angina