on May 27, 2004
Published online before print May 27, 2004, doi: 10.1161/01.STR.0000131655.45227.f7
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Submitted on December 18, 2003
From the Departments of Neurology (A. Slowik, A.B., J.P., T.D., A. Szczudlik) and Neurosurgery (M.B., T.K., R.C.), Jagiellonian University, Medical College, Krakow, Poland; and the Department of Neurology (D.A.F.), University of Michigan, Ann Arbor, Mich. * To whom correspondence should be addressed. E-mail: slowik{at}neuro.cm-uj.krakow.pl.
Background and Purpose--Evidence exists in support of a role of genetic factors in susceptibility to aneurysmal subarachnoid hemorrhage (SAH) in humans. Meta-analysis of 2 previous studies showed that the I allele of angiotensin-converting enzyme (ACE) gene insertion/deletion (I/D) polymorphism was a weak, but significant, risk factor for aneurysmal SAH. Moreover, a recent study has shown that the local renin-angiotensin system (RAS) is involved in the development of intracranial aneurysm. The aim of this study was to investigate the association between ACE I/D polymorphism and a risk for aneurysmal SAH in a Polish population. Methods--Ninety patients with aneurysmal SAH (mean age: 48.9±14.0 years) and 128 healthy controls matched for age and sex were genotyped for the ACE I/D polymorphism. Aneurysmal SAH was diagnosed by cranial computed tomography and/or lumbar puncture and digital subtraction angiography. ACE gene polymorphism was detected by polymerase chain reaction amplification of the intron 16-specific I/D fragments, 490-bp and 190-bp, respectively. Results--The ACE genotype distribution in patients with aneurysmal SAH (II, 52.2%; ID, 15.6%; DD, 32.2%) differed significantly from controls (II, 23.4%; ID, 50.8%; DD, 25.8%) (P<0.001). A logistic regression model showed that the II genotype of ACE gene was independent from female sex and smoking as a risk factor for aneurysmal SAH (OR, 4.57; 95% CI, 2.35 to 8.90). Conclusion--Here we report that II genotype of ACE gene is a risk factor for aneurysmal SAH.
Revised on March 25, 2004
Accepted on April 8, 2004
II Genotype of the Angiotensin-Converting Enzyme Gene Increases the Risk for Subarachnoid Hemorrhage From Ruptured Aneurysm
Agnieszka Slowik MD*;
Key words: aneurysm • genetics • subarachnoid hemorrhage • angiotensin-converting enzyme
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