ANGIOTENSIN CONVERTING ENZYME GENE POLYMORPHISMS IN CORONARY ARTERY DISEASE- A CONTROVERSIAL ROLE

Coronary artery disease (CAD) is the most prevalent cause of morbidity and mortality worldwide. It is a multifactorial disease, which is influenced by genetic and environmental factors. The major risk factors of CAD are age, male gender, hypertension, diabetes, hyperlipidemia, smoking, family history of CAD and obesity. Genetic factors add further information in predicting CAD. The relationship between genetic risk factors and the development of CAD is not well understood, likely due to the complex interrelation of genetic and environmental risk factors. One of the currently explored genetic factors is angiotensin converting enzyme (ACE) polymorphisms, which may have an influence on the progression of coronary artery disease. We present the results of several recently published studies (2012,2013) on the association between traditional cardiovascular risk factors and novel genetic risk factors (polymorphisms of ACE gene: insertions/deletions). The results of these studies are controversial. Most of them show an association between DD polymorphisms and D allele and the severity of stenotic coronary lesions, evaluated using the Gensini score (Gensini>6). However, others found no association. These differences may be due to geographical discrepancies, ethnical characteristics, small number of subjects included and variability of used techniques. We can therefore draw the conclusion that an international study on a large number of patients, using the same technique for genetic determination and the same statistical software should be performed.