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Angiotensin-converting enzyme gene polymorphism and risk of myocardial infarction in Colombia.

BACKGROUND
The ACE gene insertion/deletion polymorphism has been studied as a risk factor for acute myocardial infarction (AMI) in different populations with conflicting results.


MATERIAL/METHODS
We conducted a case-control study in first AMI cases matched by age (+/-5 years) and sex to controls with non-cardiac diseases to ascertain whether Colombian carriers of the DD genotype were at higher risk of AMI than carriers of the ID and II genotypes. Zygosity for the deletion-insertion (D-I) of the ACE gene polymorphism was determined by polymerase chain reaction. Logistic regression with adjustment for matching factors was used to estimate the independent effect of the DD polymorphism after controlling for traditional cardiovascular risk factors.


RESULTS
Participants (n=202) had a mean age of 62 years and 32% were women. The distribution of the polymorphism was significantly different (p=0.001) in cases (II 8.9%; ID 51.5%; DD 39.6%) and controls (II 8.9%; ID 64.4%; DD 26.7%). After adjustment for other risk factors, the risk of AMI in subjects with genotype DD was 1.98 times higher than the risk in the combined group of genotypes II and ID (95% CI: 1.01, 3.87; p=0.04). There was a significant DD by age interaction (p=0.002). In subjects p=0.86), while in subjects <60 years the risk increased 5.16 times (95% CI: 1.68, 15.90; p=0.004).


CONCLUSIONS
These results support an increased risk of AMI in Colombian subjects <60 years with the ACE DD genotype.