Title: Angiotensin converting enzyme gene D-allele, a possible risk factor for procedural complications in the coronary artery disease patients

Abstract:

Purpose: This study aimed to explore the correlations between angiotensin converting enzyme gene’s polymorphism (I/D mutations) and the intra stent restenosis, after successful revascularisation, for patients with coronary artery disease. In addition, we aimed to bring new evidence concerning the interaction between  the most common epigenetical cardiovascular  factors (diabetes, hypertension, smoking habbit and obesity), left ventricle wall motion abnormalities, the D allele and the development of restenosis.Materials and methods: We performed genetical testing on 154 patients with unstable angina and acute myocardial infarction and found that the D-allele was significantly associated with the development of coronary artery disease. We performed percutaneous revascularisation for the patients with this indication.  After excluding the patients with indication for surgical revascularisation, we selected a subgroup of 115 patients, who we followed for one year. Results 43 of the patients developped intrastent restenosis at 6 months follow up coronary angiography. We found a strong association between restenosis and ACE I/D polymorphism. 37.2% of the restenotic patients were DD genotype and 62.8% ID genotype. II genotype patients did not develop intrastent restenosis(p=0,001). Also, patients with restenosis had a greater prevalence of diabetes (88.4% vs 45.8%; p=0.001), stage III blood pressure hypertension (90.7% vs 51.4%; p=0.001), dyslipidemia(100% vs 83.3%; p=0.001), obesity  (74.4% vs 48.6%; p=0.018), smoking habbit  (60.5% vs 41.7%; p=0.039 and as far as wall motion  abnormalities were concerned, only akinesia was relevant (53.2% vs 30.6%; p=0.013).

Conclusions: The presence of the D allele was significantly associated with restenosis, especially when patients were also diabetic, hypertensive, dyslipidemic, obese and smokers. Results in this field are still controversial and more data is needed. However, our study proves useful for our geographical population.

Biography:

Maria Cristina Vladeanu is graduated from University of Medicine and Pharmacy "Grigore T. Popa" in Romania. She is a member of european society of cardiology.