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Oliviero Olivieri, Silvia Grazioli, Francesca Pizzolo, Federico Beltrame, Chiara Stranieri, Elisabetta Trabetti, PierFranco Pignatti, Ketty Boschini, Domenico Girelli, Roberto Corrocher, P-139: Deletion variant of ACE gene is associated with atherosclerotic renal artery stenosis, not with coronary artery disease. An angiographically-controlled study, American Journal of Hypertension, Volume 14, Issue S1, April 2001, Pages 76A–77A, https://doi.org/10.1016/S0895-7061(01)01748-4
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Abstract
A large body of studies has yielded conflicting evidence on the actual cardiovascular risk inherent with the carrierships of insertion/deletion (I/D) polymorphism of Angiotensin Converting Enzyme (ACE). Recently, two independent groups have reported an increased frequency of ACE D variant in patients affected by atheromatous renal artery stenosis (RAS). We compared coronary (CAD) or renal artery disease (RAS) by analyzing ACE ID polymorphism in a total of 946 patients, stratified according to two objective angiographic criteria:
i) patients with or or without evidence of coronary artery disease (n=454 and n=242, respectively).
ii) patients with or without evidence of renal artery stenosis (n=122 and n=134, respectively).
RAS- free subjects were selected among patients with angiographically documented coronaropathy, so that both renal and coronary angiographic data were available.
CAD patients presented more conventional cardiovascular risk factors than those free of coronary artery disease. On the contrary, no substantial differences were observed between RAS and RAS-free patients with the only relevant exceptions of age and creatinine values that were higher in patients affected by RAS.The distribution of ACE DD genotype was similar in CAD and CAD-free patients (38.7 vs 34.7%, p=NS). In contrast, the frequency of DD genotype in RAS patients was significantly higher than that in the RAS-free subjects (54.1 vs 38.1%, p<0.05).
Conclusion: i) D variant of ACE gene is associated with atherosclerotic renal artery stenosis, but not with CAD; ii) despite similar exposition to conventional risk factors, carriership of D variant yields different clinical outcomes; iii) this is the first demonstration of a genetic role in predisposing to a selective localization of atherosclerotic damage.
