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O polimorfismo do gene da ECA está associado com a gravidade e extensão da doença coronária
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Advisor(s)
Abstract(s)
Introdução: Os doentes com doença das
artérias coronárias (DAC) apresentam
extensão da doença e evolução muito
variáveis, que muito vezes nos escapam e que
ultrapassam os factores de risco tradicionais.
As diferenças poderão, pelo menos em parte,
ser explicáveis por polimorfismos genéticos
menos favoráveis que lhe estejam associados.
Os polimorfismos do gene da ECA têm sido
profusamente avaliados, embora se
desconheça a ligação entre estes
polimorfismos e a extensão da DAC.
Objectivo: Os autores pretendem avaliar se os
polimorfismos do gene da enzima de conver são da Angiotensina I (ECA) constituem um
marcador da extensão e gravidade da DAC.
Métodos: Estudo descritivo, em 296 doentes
com história de enfarte do miocárdio ou
doença coronária confirmada por
coronariografia, com pelo menos 75 % de
obstrução de um dos vasos coronários.
A quantificação da gravidade e extensão, foi
feita segundo o score de Leaman, de acordo
com o número de artérias com redução do
diâmetro superior a 75 %, e com o número de
segmentos coronários afectados.
Os genotipos do ECA, foram tipados por
amplificação por PCR e os produtos de
amplificação separados por electroforese em
gel de poliacrilamida. Calculou-se a média e desvio padrão dos
scores coronários dos três polimorfismos e os
valores foram comparados estatisticamente
recorrendo ao teste T de Student para
amostras independentes.
Resultados e Conclusão: O genotipo DD
aparece neste estudo claramente ligado à
extensão da DAC, com um alto grau de
significância. A confirmar-se este conceito,
poderá justificar-se fazer uma prevenção
secundária particularmente cuidadosa nos
doentes vasculares portadores deste genotipo.
Background: The progression and extent of coronary heart disease (CHD) are extremely variable and in many instances independent of conventional risk factors. The differences may be partly explained by less favorable genetic polymorphisms that are associated with them. The polymorphisms of the angiotensin I converting enzyme (ACE) gene have been thoroughly evaluated, but the connection between them and the extent of CHD is unknown. Aims: Our study is aimed at determining whether any or all of the polymorphisms of the ACE gene are markers of the extent and severity of CHD. Methods: This was a descriptive study of 296 patients with a history of myocardial infarction or with coronary disease confirmed by coronary angiography. The severity of CHD was quantified according to Leaman’s score (based on the number of arteries with more than 75 % reduction in diameter and the number of affected coronary segments). The ACE genotypes were determined by specific polymerase chain reaction amplification and the segments were subjected to polyacrylamide gel electrophoresis. The mean coronary score and standard deviation of the three polymorphisms were calculated and the values statistically compared using the Student’s t test for independent samples. Results: 296 patients with a mean age of 5510.3 years, 234 male, were evaluated. Conclusion: The study clearly shows that the DD genotype is linked to the extent of CHD, with a high level of significance. If this is confirmed, careful secondary prevention is indicated in patients with this genotype.
Background: The progression and extent of coronary heart disease (CHD) are extremely variable and in many instances independent of conventional risk factors. The differences may be partly explained by less favorable genetic polymorphisms that are associated with them. The polymorphisms of the angiotensin I converting enzyme (ACE) gene have been thoroughly evaluated, but the connection between them and the extent of CHD is unknown. Aims: Our study is aimed at determining whether any or all of the polymorphisms of the ACE gene are markers of the extent and severity of CHD. Methods: This was a descriptive study of 296 patients with a history of myocardial infarction or with coronary disease confirmed by coronary angiography. The severity of CHD was quantified according to Leaman’s score (based on the number of arteries with more than 75 % reduction in diameter and the number of affected coronary segments). The ACE genotypes were determined by specific polymerase chain reaction amplification and the segments were subjected to polyacrylamide gel electrophoresis. The mean coronary score and standard deviation of the three polymorphisms were calculated and the values statistically compared using the Student’s t test for independent samples. Results: 296 patients with a mean age of 5510.3 years, 234 male, were evaluated. Conclusion: The study clearly shows that the DD genotype is linked to the extent of CHD, with a high level of significance. If this is confirmed, careful secondary prevention is indicated in patients with this genotype.
Description
Keywords
Doença coronária Genes Polimorfismo Coronary disease Gene Polymorphism . Faculdade de Ciências da Vida
Citation
Mendonça, I., Freitas, I. A., Sousa, C. A., Gomes, S., Faria, P., Drumond, A., ... & dos Reis, R. P. (2004). Polymorphism of the ACE gene is associated with extent and severity of coronary disease. Revista Portuguesa de Cardiologia: Orgao Oficial da Sociedade Portuguesa de Cardiologia= Portuguese Journal of Cardiology: an Official Journal of the Portuguese Society of Cardiology, 23(12), 1605-1611.