PMID- 12628714
OWN - NLM
STAT- MEDLINE
DCOM- 20030327
LR  - 20190708
IS  - 0735-1097 (Print)
IS  - 0735-1097 (Linking)
VI  - 41
IP  - 5
DP  - 2003 Mar 5
TI  - Angiotensin-converting enzyme gene polymorphism interacts with left ventricular 
      ejection fraction and brain natriuretic peptide levels to predict mortality after 
      myocardial infarction.
PG  - 729-36
AB  - OBJECTIVES: The goal of this study was the exploration of the associations 
      between the angiotensin-converting enzyme (ACE) gene insertion/deletion (I/D) 
      polymorphism and post-myocardial infarction (MI) outcomes, especially any 
      interaction with the accepted clinical prognostic markers brain natriuretic 
      peptide (BNP) and left ventricular ejection fraction (LVEF). BACKGROUND: The ACE 
      gene I/D polymorphism has been implicated in the development of MI, hypertension, 
      and left ventricular hypertrophy. We examined the association of ACE I/D and 
      prognosis after acute MI. METHODS: Patients incurring acute MI were genotyped for 
      the ACE I/D polymorphism. Clinical data included assays of neurohormones, 
      radionuclide ventriculography, and mortality over a mean 2.6 years of follow-up. 
      RESULTS: Patients (n = 978) had a mean age of 62.1 years, and 78% were male. 
      Overall genotype frequencies were II 23.2%, ID 49.5%, and DD 27.3%. Chi-square 
      analysis revealed an association between the ACE D allele and death after MI (88 
      of 103 who died were DD or ID; p < 0.05), with an odds ratio for mortality of 
      8.03 (95% confidence interval, 2.16 to 29.88). Patients with the DD genotype had 
      higher (p < 0.05) plasma BNP, N-terminal BNP (N-BNP), and endothelin-1 levels 
      within 96 h after MI than grouped ID/II patients. Multivariate analysis indicated 
      ACE genotype, age, and previous MI were independent predictors of death (p < 
      0.05). Patients with an ACE D allele in combination with either a lower than 
      median LVEF or greater than median BNP had a higher mortality (p < 0.001 and p < 
      0.025, respectively) than the risk associated with the D allele itself. 
      CONCLUSIONS: Angiotensin-converting enzyme genotyping may provide additional 
      prognostic information in patients after MI in combination with the proven 
      utility of LVEF, plasma BNP, and N-BNP measurements.
FAU - Palmer, Barry R
AU  - Palmer BR
AD  - Christchurch Cardioendocrine Research Group, Department of Medicine, Christchurch 
      School of Medicine and Health Sciences, Christchurch, New Zealand.
FAU - Pilbrow, Anna P
AU  - Pilbrow AP
FAU - Yandle, Tim G
AU  - Yandle TG
FAU - Frampton, Chris M
AU  - Frampton CM
FAU - Richards, A Mark
AU  - Richards AM
FAU - Nicholls, M Gary
AU  - Nicholls MG
FAU - Cameron, Vicky A
AU  - Cameron VA
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - J Am Coll Cardiol
JT  - Journal of the American College of Cardiology
JID - 8301365
RN  - 0 (Biomarkers)
RN  - 114471-18-0 (Natriuretic Peptide, Brain)
RN  - EC 3.4.15.1 (Peptidyl-Dipeptidase A)
SB  - IM
CIN - J Am Coll Cardiol. 2003 Nov 19;42(10):1864; author reply 1864. PMID: 14642700
MH  - Aged
MH  - Biomarkers/analysis
MH  - Cohort Studies
MH  - Electrocardiography
MH  - Female
MH  - Genotype
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/diagnosis/*genetics/metabolism/*mortality
MH  - Natriuretic Peptide, Brain/*analysis
MH  - Peptidyl-Dipeptidase A/analysis/*genetics
MH  - *Polymorphism, Genetic
MH  - Predictive Value of Tests
MH  - Probability
MH  - Prognosis
MH  - Sensitivity and Specificity
MH  - Severity of Illness Index
MH  - Stroke Volume
MH  - Survival Analysis
MH  - Ventricular Dysfunction, Left/*genetics/physiopathology
EDAT- 2003/03/12 04:00
MHDA- 2003/03/28 05:00
CRDT- 2003/03/12 04:00
PHST- 2003/03/12 04:00 [pubmed]
PHST- 2003/03/28 05:00 [medline]
PHST- 2003/03/12 04:00 [entrez]
AID - S0735109702029273 [pii]
AID - 10.1016/s0735-1097(02)02927-3 [doi]
PST - ppublish
SO  - J Am Coll Cardiol. 2003 Mar 5;41(5):729-36. doi: 10.1016/s0735-1097(02)02927-3.