The angiotensin converting enzyme D allele is an independent risk factor for early onset coronary artery disease

Objective: The role of angiotensin converting enzyme (ACE) gene insertion/deletion (I/D) polymorphism in early onset coronary artery disease age <55 years (ECAD) is controversial. The aim of this study was to further evaluate the role of this ACE(I/D) gene polymorphism on the risk of premature CAD in patients from western Iran. Methods: The ACE(I/D) genotypes were detected by PCR-RFLP in 323 individuals undergoing their first coronary angiography. Patients were placed into two groups: ECAD and late onset CAD age 55 years (LCAD). Results: We found a statistically significant association of the ACED allele, as homozygous or ACE ID plus DD genotypes (ID DD), only in the ECAD subjects OR = 1.35, p = 0.015, OR = 3.27, p = 0.014, and OR = 2.8, p = 0.013, respectively. In addition, there was a significant association after adjustment for the absence of history of diabetes, presence of normolipidemia and absence of history of blood pressure [OR 1.38, p = 0.017 and 2.35, p = 0.02]. Our results indicated that the ACE D allele is a risk factor for early onset of CAD even after correcting for conventional risk factors. The incidence of triple vessel disease was significantly higher in individuals carrying ACE(D/D) genotype in ECAD patients compared to those who carried ACE(I/I) genotype (OR 3.38; p = 0.019; 57.5% vs. 42.5%; p = 0.013). Conclusion: The presence of D allele of ACE can be important independent risk factor in the onset of CAD patients less than 55 years old in a west population of Iran. Larger collaborative studies are needed to confirm these results. (C) 2010 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.