The Effect of Angiotensin-Converting Enzyme Gene Polymorphisms in the Coronary Slow Flow Phenomenon at South Sumatra, Indonesia Population

Ali Ghanie; Radiyati Umi Partan; Taufik Indrajaya; Zulkhair Ali; Mgs Irsan Saleh; Rachmat Hidayat

doi:10.3889/oamjms.2020.3802

Authors

Ali Ghanie Cardiology Division, Department of Internal Medicine, Faculty of Medicine, Universitas Sriwijaya, Palembang, Indonesia
Radiyati Umi Partan Rheumatology Division, Department of Internal Medicine, Faculty of Medicine, Universitas Sriwijaya, Palembang, Indonesia
Taufik Indrajaya Cardiology Division, Department of Internal Medicine, Faculty of Medicine, Universitas Sriwijaya, Palembang, Indonesia
Zulkhair Ali Nephrology Division, Department of Internal Medicine, Faculty of Medicine, Universitas Sriwijaya, Palembang, Indonesia
Mgs Irsan Saleh Department of Pharmacology, Faculty of Medicine, Universitas Sriwijaya, Palembang, Indonesia
Rachmat Hidayat Department of Biology, Faculty of Medicine, Universitas Sriwijaya, Palembang, Indonesia

DOI:

https://doi.org/10.3889/oamjms.2020.3802

Keywords:

Angiotensin Converting Enzyme, Renin-Angiotensin Aldosterone System, Gene Polymorphisms, Coronary Slow Flow Phenomenon

Abstract

BACKGROUND: The coronary slow flow phenomenon (CSFP) is believed to be affected by endothelial dysfunction ruled by renin, angiotensin, aldosterone, and the angiotensin-converting enzyme (ACE). The gene of ACE has been characterized in humans by a major insertion (I)/deletion (D) polymorphism. Serum ACE levels were associated with I/D polymorphism in the ACE-encoding gene.

AIM: This study explored and analyzed the role of ACE gene polymorphism risk factors with the incidence of CSFP in the population of South Sumatra, Indonesia.

METHODS: This study was a cross-sectional analytic observational study. A total of 112 CSFP and non- CSFP patients participated in this study. Blood was obtained from the study subjects then processed. Angiotensin I and aldosterone levels were examined using the enzyme-linked immunosorbent assay. The Judkins method was used in the assessment of coronary angiography, which was carried out through the femoral artery. For the examination of ACE I/D polymorphisms, genome deoxyribonucleic acid was extracted from blood cells (leukocytes), using the Wizard’s purification system and examined using the polymerase chain reaction method. All data were evaluated through the Chi-square test, two samples t-test, and Mann–Whitney U-test. All tests used two-sided significance and p < 0.05 was considered statistically significant.

RESULTS: ACE I/D gene polymorphism possessed a significant effect in increasing the risk of CSFP. Genotype II polymorphism increased the risk of CSFP as much as 6.9 times compared to individuals with ID/DD genotype. The existence of allele I increased the risk of CSFP 5.7 times compared to allele D. Levels of angiotensin I and aldosterone were increased significantly in patients with CSFP.

CONCLUSION: ACE I/D gene polymorphism possessed a significant effect in increasing the risk of CSFP. Genotype of II was the risk factor for the development of CSFP in population of South Sumatra, Indonesia.

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