ACE I/D Polymorphism And Premature Coronary Artery Disease: Evidence From Young Indian Patients

Abstract

Introduction: Coronary artery disease (CAD) is the leading global cause of mortality and affects South Asians a decade earlier than Western populations. Beyond conventional risk factors, genetic determinants—particularly the angiotensin-converting enzyme (ACE) insertion/deletion (I/D) polymorphism—may influence susceptibility. This study assessed the association of ACE I/D polymorphism in young-onset CAD patients and its relation to biochemical parameters.

Methods: A case–control study included 100 angiographically proven CAD patients aged ≤45 years and 100 age- and sex-matched healthy controls. Demographic, clinical, and biochemical data were collected, and ACE I/D genotyping was performed using polymerase chain reaction. Genotype and allele frequencies were compared, and associations with fasting glucose and lipid profile were analyzed. Odds ratios with 95% confidence intervals were calculated.

Results and Conclusion: The distribution of ACE genotypes differed significantly between CAD patients and controls. The DD genotype was more frequent in CAD patients, while the II genotype was more common in controls. The D allele frequency was significantly higher in cases (0.56) compared to controls (0.375). The DD genotype conferred increased risk under both dominant and recessive models (OR=0.32 and 0.45, respectively). Biochemical analysis revealed that ID+DD carriers had higher fasting glucose and significantly lower HDL-C compared to II carriers, both in cases and controls. The ACE I/D polymorphism, particularly the DD genotype and D allele, is strongly associated with young-onset CAD in the study population. Incorporating genetic screening into risk stratification may facilitate early identification and preventive interventions in high-risk individuals.