Risk of ischemic heart and ischemic cerebrovascular disease is not increased in S, Z, and 11478A alpha1-antitrypsin carriers of the Copenhagen City Heart Study.

Abstract

To the Editor: In a study of 395 men, Talmud and coworkers1 found a trend toward increased atherosclerosis progression in α1-antitrypsin deficiency S and Z carriers and a significantly increased atherosclerosis progression in α1-antitrypsin 11478A carriers compared with noncarriers. As opposed to this, recent studies suggest the opposite, a protective role of α1-antitrypsin deficiency against atherosclerotic disorders.2,3 In our study of 11,315 men and women, severe ZZ α1-antitrypsin deficiency and intermediate MZ deficiency were associated with reduced blood pressure, and MZ was also associated with reduced risk of ischemic cerebrovascular disease (ICVD) and ischemic heart disease (IHD).2 The MS genotype did not affect blood pressure or risk of IHD and ICVD in our study. We also screened subjects for the less severe 11478A variant in the α1-antitrypsin gene4 but never previously reported on risk of IHD and ICVD for this variant. Among men, odds ratios for IHD and ICVD in 11478A carriers versus noncarriers were 0.93 (0.76 to 1.1) and 0.98 (0.72 to 1.3). When these …