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Interaction Between Gene Polymorphisms of Renin-angiotensin System and Metabolic Risk Factors in Premature Myocardial Infarction

Danijel Petrovi, MD, PhD

Institute of Histology and Embryology, Medical Faculty Ljubljana; the Teaching Hospital Maribor, Maribor; and the Division of Medical Genetics, Department of Obstetrics and Gynecology, Medical Centre Ljubljana, and Department of Cardiology, Ljubljana, Slovenia

Marjeta Zorc, MD, PhD

Institute of Histology and Embryology, Medical Faculty Ljubljana; the Teaching Hospital Maribor, Maribor; and the Division of Medical Genetics, Department of Obstetrics and Gynecology, Medical Centre Ljubljana, and Department of Cardiology, Ljubljana, Slovenia

Vojko Kani, MD

Teaching Hospital Maribor, Maribor, Medical Centre Ljubljana, and Department of Cardiology, Ljubljana, Slovenia

Borut Peterlin, MD, PhD

Division of Medical Genetics, Department of Obstetrics and Gynecology, Medical Centre Ljubljana, and Department of Cardiology, Ljubljana, Slovenia.

The renin-angiotensin system is involved in the pathogenesis of coronary artery disease (CAD) and myocardial infarction (MI). The authors investigated the association of genetic variability in the renin-angiotensin system (RAS) with premature MI and interactive effects between gene polymorphisms and metabolic risk factors on MI risk. Their study compared 142 patients with MI younger than 55 years with 142 healthy subjects. Polymorphisms of angiotensin-I converting enzyme (ACE) gene (insertion/deletion), angiotensinogen gene (M235T), and angiotensin-II type-1 receptor (AGT ₁R) gene (A1166C) were tested. The ACE-DD (deletion/deletion) genotype conferred a twofold independent risk for MI (confidence interval [CI] = 1.1-3.7; p=0.01) after adjustment for cardiovascular risk factors, whereas angiotensinogen-TT genotype and AGT₁R- AA genotype were not independent risk factors for MI. An interactive effect on MI risk was found between ACE-DD and AGT₁R-AA genotypes (odds ratio [OR] = 2, 95% CI = 1-3.9), between ACE-DD and angiotensinogen-TT genotypes (OR=2.7, 95% CI= 1-7.3), as well as among ACE-DD, angiotensinogen-TT, and AGT₁R-AA genotypes (OR = 4.8, 95% CI = 1-22.8). Similarly, metabolic risk factors interacted with angiotensinogen-TT genotype (OR=2, 95% CI = 1.1-3.9) on MI risk. The ACE-DD genotype is an independent risk factor for MI in patients younger than 55 years. Additionally, the authors provide evidence of an interactive effect on MI risk between risk genotypes of RAS, as well as between the angiotensinogen-TT genotype and metabolic risk factors.

Angiology, Vol. 52, No. 4, 247-252 (2001)
DOI: 10.1177/000331970105200403


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