ACE and ADD1 gene in extra and intracranial atherosclerosis in ischaemic stroke

Abstract

Objective: Hypertension is closely linked to ischaemic stroke (IS) and atherosclerosis, but there are no studies correlating the candidate hypertensive gene, namely angiotensin converting enzyme (ACE) and adducin 1 (ADD1) with magnetic resonance angiographic (MRA) abnormality, therefore this study was undertaken.Methods: Patients with magnetic resonance imaging (MRI) proven IS were included and their demography, stroke risk factors, and clinical findings were noted. Both intracranial (IC) and extracranial (EC) MRA were performed and more than 50% stenosis was considered significant. Angiotensin converting enzyme and ADD1 gene polymorphism was evaluated by polymerase chain reaction (PCR) both in patients and 188 controls.Results: Angiotensin converting enzyme and ADD1 polymorphism were performed in 151 patients whose median age was 60 years and 26·5% were females. Magnetic resonance angiography was abnormal in 77·5%; extracranial magnetic resonance angiography (ECMRA) in 58·3%, and intracranial magnetic resonance angiography (ICMRA) in 66·7%. The conventional risk factors were not different between the IS patients with and without MRA abnormalities. The presence of DD genotype (OR 3·86, 95% CI 0·78–2·28, P = 0·0001) and ADD1 GW genotype (OR 2·05, 95% CI 1·28–3·27, P = 0·003) significantly increased the risk of IS compared to controls. Both genotype and allele frequency of ACE and ADD1 were higher in MRA abnormal IS patients compared to controls; however, these were not significantly different between the patients with and without MRA abnormality.Conclusion: In IS patients, DD genotype and D allele of ACE gene and W allele of ADD1 gene were significantly related to MRA abnormality compared to controls but there was no association of ACE and ADD1 gene polymorphism in IS patients with MRA and without abnormality.