ACE DD genotype

Fatini C, Gensini F, Sticchi E et al (2003) ACE DD genotype an independent predisposition factor to venous thromboembolism. Eur J Clin Invest 33 642-647... 

Cicoira M, Zanolla L, Rossi A et al (2001) Failure of aldosterone suppression despite angiotensin-converting enzyme (ACE) inhibitor administration in chronic heart failure is associated with ACE DD genotype. J Am Coll Cardiol 37 1808-1812... 

The adverse impact of the deletion on heart failure progression was dramatic in patients not treated with P-blockers. Two-year patient survival was 81% in ACE insertion, II genotype 48% in ACE deletion, DD genotype and 61% in the heterozygote, ID genotype. In contrast, patients who received P-blocker therapy showed no influence of the ACE genotype on transplant-free survival. Two-year patient survival was 70% in the II, 71% in the ID, and 77% in the DD genotypes. 

The ACE gene insertion/deletion (ED) polymorphism was characterized in 345 patients who were undergoing coronary stenting. Among them, 115 had the DD genotype. The investigators assigned 91 of these patients to quinapril 40 mg daily or placebo. Treatment was initiated within 48 hours after stent implantation and continued for 6 months. 

ACE inhibitors are widely prescribed for patients with atherosclerosis, hypertension, or diabetes, and after myocardial infarction, because of proven beneficial effects in each of these groups. In light of the results in the setting of stent restenosis, whether a patient with hypertension or some other target disorder who carries the DD genotype derives less benefit from ACE inhibitor therapy warrants consideration. 

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