963-16 Variant Angina is not Associated with Insertion/Deletion Polymorphism of Angiotensin-I Converting Enzyme (ACE) Gene

Abstract

D allele of insertion/deletion polymorphism of angiotensin-I converting enzyme (ACE) gene was reported to be associated with myocardial infarction and ischemic cardiomyopathy. It was suggested that the possible mechanism of these of associations might be coronary artery vasopasm. We therefore studied to know whether variant angina is related with polymorphism of ACE gene. Four groups of patients were studied; (1) variant angina group (n = 64) who received coronary angiography and provocation test using ergonovine or acetylcholine, (2) normal control group (n = 66) whose coronary angiogram was normal, (3) acute ischemic syndrome group (n = 76). (4) chronic stable angina group (n = 25). Genomic DNA was extracted from mononuclear cells of peripheral blood and PCR was done. Distribution of genotypic frequency of normal controls (DD : ID: II = 0.152 : 0.500 : 0.348, D allele: I allele = 0.402: 0.598) is different from that of Caucasians (p < 0.005) but similar to that of Japanese. Distribution of genotypic frequency of variant angina (DD : ID : II = 0.094: 0.625 : 0.281, D : I = 0.406: 0.594) is neither significantly different from that of normal controls nor that of ischemic heart disease groups. Furthermore. it is not different from that of patients (n = 22) who had negative results provocation test (DD : ID : II = 0.182 : 0.409 : 0.409, D : I = 0.386 : 0.614). In acute ischemic syndrome patients, D allele was more frequent in patients with normal cholesterol level than in patients with high cholesterol level (p < 0.05). Among patients without hypertension, DD homozygotes were more frequent in patients with high left ventricular mass index than low ventricular mass index (p < 0.05). The findings suggest that insertion/deletion polymorphism of ACE gene is not associated with variant angina, butit is associated with the development of acute ischemic syndrome in low risk group and the development of left ventricular hypertrophy.