Abstract 14376: Ace I/d Polymorphism is a Risk Factor for Thoracic Aortic Aneurysm in Patients With Bicuspid or Tricuspid Aortic Valves
Background: The angiotensin-converting enzyme (ACE) is highly expressed in aneurysmal vascular wall, both in animal models and human disease. Genetic variations in ACE may be crucial in determining the risk of thoracic aortic aneurysm (TAA).
Objective: The aim of this study was to examine the role of ACE insertion/deletion(ACE I/D) polymorphism in the risk of TAA in patients with bicuspid (BAV) or tricuspid aortic valves (TAV).
Methods: From January 2008 to December 2009, we enrolled a group of 206 patients (149 male; age=59.1±14.9 years) who were referred to our Cardiac Surgery Department for TAA, associated with BAV (n=96) and TAV (n=110), and a group of 312 patients (252 male; age=54.6±11.0 years) with angiographically-proven coronary artery disease (CAD). A group of 300 healthy subjects (91 male; age=40.2±10.6 years) was used as control group.
Results: The genotype distribution and allele frequency of ACE I/D were significantly different between the patients with TAA when compared to CAD (p=0.04) and controls (p=0.0006). There was no significant difference in the genotype frequency between the control group and the CAD patients (p=0.3). Compared with controls, both BAV patients (p=0.02) and TAV patients (p=0.0004) had higher frequency of allele D. Aortic diameters were also significantly different among the three genotypes (48.3±6.5, 45.1±8.9, 38.9±9.0, p=0.0002, for DD, DI, II genotypes respectively). There was also a synergistic significant effect between ACE D allele and hypertension for both increased aortic diameter and the risk for TAA (Figure). On multivariate logistic regression analysis, hypertension [OR=2.5 (95% CI: 1.0–6.1) p=0.04], age [OR=1.0 (95% CI: 1.0–1.1) p=0.02] and D allele [OR=4.2 (95% CI: 1.3–13.4) p=0.01] were significant determinants for TAA.
Conclusions: ACE I/D polymorphism represents a genetic biomarker for TAA.
- © 2010 by American Heart Association, Inc.