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(Hypertension. 1995;25:950-953.)
© 1995 American Heart Association, Inc.

Articles

Enhanced Predictability of Myocardial Infarction in Japanese by Combined Genotype Analysis

Atsushi Kamitani; Hiromi Rakugi; Jitsuo Higaki; Mitsuru Ohishi; Shang-Jin Shi; Seiju Takami; Yukiko Nakata; Yorihiko Higashino; Kenshi Fujii; Hiroshi Mikami; Tetsuro Miki; Toshio Ogihara

From the Department of Geriatric Medicine, Osaka (Japan) University Medical School (A.K., H.R., J.H., M.O., S.-J.S., S.T., Y.N., H.M., T.M., T.O.); and the Division of Cardiology, Sakurabashi-Watanabe Hospital, Osaka (Y.H., K.F.), Japan.

Correspondence to Toshio Ogihara, MD, Department of Geriatric Medicine, 2-2 Yamada-oka, Suita, Osaka 565, Japan.

Abstract To explore the genes responsible for myocardial infarction and restenosis after percutaneous transluminal coronary angioplasty, we performed association studies of the polymorphisms of the angiotensinogen and angiotensin-converting enzyme (ACE) genes. In the first study, normotensive myocardial infarction patients (n=103) and control subjects (n=103), who were matched for established risk factors with the myocardial infarction patients, were randomly selected. The angiotensinogen-TT genotype (T indicates threonine instead of methionine at position 235) was more frequent in the myocardial infarction group than in the control group (P<.05). The ACE-DD genotype (D indicates a deletion polymorphism in intron 16) was also more frequent in the myocardial infarction group (P<.0001). The odds ratio estimated by the combined analysis of the angiotensinogen-TT and ACE-DD genotypes (11.2) was markedly increased compared with that estimated separately from the angiotensinogen-TT (1.75) or ACE-DD (4.43) genotype. In the second study, we investigated 91 consecutive patients with acute myocardial infarction who underwent successful direct angioplasty. Combined analysis showed that the angiotensinogen-TT genotype did not enhance the predictability of myocardial infarction from the ACE-DD genotype. In conclusion, the angiotensinogen-TT genotype is a predictor for myocardial infarction, as well as the ACE-DD genotype, and the combined analysis of the angiotensinogen-TT and ACE-DD genotypes further enhanced the predictability of myocardial infarction in Japanese, suggesting its future clinical usefulness.

Key Words: myocardial infarction • angiotensinogen • angiotensin-converting enzyme • genotype

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