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Deletion polymorphism in the gene for angiotensin-converting enzyme is a potent risk factor for myocardial infarction

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Abstract

FACTORS involved in the pathogenesis of atherosclerosis, thrombosis and vasoconstriction1,2 contribute to the development of coronary heart disease. In a study comparing patients after myocardial infarction with controls, we have explored a possible association between coronary heart disease and a variation found in the gene encoding angiotensin-converting enzyme (ACE). The polymorphism ACE /ID is strongly associated with the level of circulating enzyme3. This enzyme plays a key role in the production of angiotensin II and in the catabolism of bradykinin, two peptides involved in the modulation of vascular tone and in the proliferation of smooth muscle cells. Here we report that the DD genotype, which is associated with higher levels of circulating ACE than the ID and II genotypes, is significantly more frequent in patients with myocardial infarction (n=610) than in controls (n=733) (P = 0.007), especially among subjects with low body-mass index and low plasma levels of ApoB (P< 0.0001). The ACE/ID polymorphism seems to be a potent risk factor of coronary heart disease in subjects formerly considered to be at low risk according to common criteria.

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Authors and Affiliations

  1. INSERM SC7,17 rue du Per à Moulin, 75005, Paris, France

    François Cambien, Odette Poirier, Laure Lecerf & Sylvain Ricard

  2. INSERM U258, Hôpital Broussais, 96 rue Didot, 75674, Paris, France

    François Cambien & Laurence Tiret

  3. MONICA Project, The Queen's University, Belfast, BT12 6BJ, UK

    Alun Evans

  4. MONICA Project, INSERM U326, CHU Purpan, 31059, Toulouse, France

    Jean-Pierre Cambou

  5. MONICA Project, 11 rue Humann, 67085, Strasbourg, France

    Dominique Arveiler

  6. MONICA Project, Institut Pasteur, 59019, Lille, France

    Gerald Luc & Philippe Amouyel

  7. SERLIA-INSERM U325, Institut Pasteur, 59019, Lille, France

    Jean-Marie Bard

  8. Laboratoire de Thrombose Expérimentale, 15 rue de I'Ecole de Médecine, 75005, Paris, France

    Lucienne Bara

  9. INSERM U367, 17 rue du Fer à Moulin, 75005, Paris, France

    François Alhenc-Gelas

  10. INSERM U36, 3 rue d'Ulm, 75005, Paris, France

    Florent Soubrier

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  1. François Cambien
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  2. Odette Poirier
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  3. Laure Lecerf
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  4. Alun Evans
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  5. Jean-Pierre Cambou
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  6. Dominique Arveiler
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  7. Gerald Luc
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  8. Jean-Marie Bard
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  9. Lucienne Bara
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  10. Sylvain Ricard
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  11. Laurence Tiret
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  12. Philippe Amouyel
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  13. François Alhenc-Gelas
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  14. Florent Soubrier
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Cambien, F., Poirier, O., Lecerf, L. et al. Deletion polymorphism in the gene for angiotensin-converting enzyme is a potent risk factor for myocardial infarction. Nature 359, 641–644 (1992). https://doi.org/10.1038/359641a0

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  • DOI: https://doi.org/10.1038/359641a0

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