Systematic review and meta-analysis of ACE insertion/deletion variant on cardiometabolic profile, premature coronary artery disease and severity of coronary lesions

Abstract

Abstract Angiotensin-converting enzyme (ACE) is closely related to cardiometabolic risk factors and atherosclerosis. This study investigates whether the ACE variant impacts cardiometabolic profile, premature coronary artery disease (PCAD), and severity of coronary lesions. In total, 91 studies (94,270 individuals) were included for the analysis. The rs4646994 (an insertion/deletion variant in the ACE gene) D allele was linked to a higher levels of low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), systolic blood pressure (SBP), diastolic blood pressure (DBP), body mass index (BMI), and waist circumference (WC). The D allele of rs4646994 was associated with a higher risk of PCAD and multiple vessel lesions. The impactsof rs4646994 on lipid levels were significant in Asians but stronger in females. In contrast, the impacts of rs4646994 on blood pressure, PCAD, and severity of coronary lesions were significant in Caucasians and males. Our study suggested that rs4646994 had a slight but significant impact on cardiometabolic risk factors, PCAD, and severity of coronary lesions. Angiotensin-converting enzyme inhibitors (ACEI) may benefit high-risk populations (eg, Caucasians, males, and females with high LDL-C levels) with rs4646994 to prevent PCAD and multiple vessel lesions.