Research ArticleOriginal Article
Open Access

Angiotensin converting enzyme polymorphism and ischemic stroke

Gelan M. Salem and Ghada K. Gab-Allah
Neurosciences Journal July 2020, 25 (3) 176-181; DOI: https://doi.org/10.17712/nsj.2020.3.20190117

Article Figures & Data

Figures

  • Figure 1
    Figure 1

    Shows ACE I/D genotypes: Lane 1 shows 50bp ladder, lane 2,3,4,6,7,15,17 show ID genotype at 190,490bp,lane5,8,9,10,12,13 show DD genotype at 190bp while lane 11 shows II genotype at 490bp.

Tables

  • Table 1

    Shows stroke risk factors, severity and etiological classification.

    ItemsPatientsn=70Controlsn=30χ2P-value
    n (%)
    Age (years)
    Mean±SD56.17±9.6153.13±8.801.49*0.141
    Gender
    Male48 (68.6)16 (53.3)2.120.146
    Females22 (31.4)14 (46.7)
    DM38 (54.3)026.27<0.001
    HTN26 (40.0)016.67<0.001
    Obesity16 (22.9)08.160.004
    Cardiac risk
    No54 (77.1)30 (100)8.060.043
    AF4 (5.7)0
    Others6 (8.6)0
    AF& others6 (8.6)0
    Hyperlipidemia30 (42.9)018.37<0.001
    Smoking10 (14.3)04.760.029
    Migraine4 (5.7)01.790.181
    TIAS8 (11.4)03.730.054
    Recurrent attach14 (20.0)06.980.008
    Toast classifications attack
    1 (small vessel stenosis)36 (51.5)
    2 (large vessel stenosis)24 (34.2)
    3 (cardioembolism)10 (14.3)
    NIHSS range2-12
    Mean±SD6.89±2.56
    Minor stroke less than 512 patients
    Moderate (5-15)58 patients

    • ↵* student t-test was used

    • DM - diabetes mellitus

    • HTN–hypertension

    • NIHSS - National Institute Health Stroke Scale

    • SD - standard deviation

    • TIA - transient ischemic attack

    • AF - atrial fibrilation

  • Table 2

    Genotypic variations of ACE among Egyptian ischemic stroke patients.

    ItemsPatientsn=70N (%)Controlsn=30χ2P-valueOR (95% CI)
    Gene polymorphism of ACE:0.316
    DD26 (37.1)16 (53.3)2.31P1=0.2030.54 (0.21-1.40)
    ID30 (42.9)10 (33.3)P2=0.2320.46 (0.13-1.66)
    II14 (20.0)4 (13.3)P3=0.8191.17 (0.31-4.37)
    ID+II vs DDID+DD vs II2.260.630.1330.4260.82 (0.62-1.08)1.63 (0.49-5.42)
    ACE gene alleles:n=140n=60
    D alleles82 (58.6)42 (70.0)2.330.1271.65 (0.86-3.15)
    I alleles58 (41.4)18 (30.0)

    • OR - Odd’s ratio

    • CI - Confidence interval

    • P1 - DD vs ID

    • P2 - DD vs II

    • P3 - II vs ID

    • ACE - Angiotensin Converting Enzyme

    • DD - Deltion/Deltion genotype

    • ID - Insertion/Deletion genotype

    • II - Insertion/iInsertion genotype

  • Table 3

    Angiotensin converting enzyme gene polymorphism (ACE) as regards TOASTclassification in ischemic stroke patients.

    ItemsTOAST classificationχ2P-value
    SVSn=36LVSn=24N (%)Cardiacn=10
    ACE gene polymorphism0.031
    DD10 (27.8)8 (33.3)8 (80.0)10.64p1=0.605
    ID16 (44.4)12 (50.0)2 (20.0)p2=0.009
    II10 (27.8)4 (16.7)0p3=0.039
    n=72n=48n=20
    ACE gene alleles
    D alleles36 (50.0)28 (58.3)18 (90.0)10.320.006
    I alleles36 (50.0)20 (40.7)2 (10.0)p1=0.370
    p2=0.001
    p3=0.011

    • p1 - SVS vs LVS

    • p2 - SVS vs cadiac

    • p3 - LVS vs cardiac

    • SVS - small vessel stroke

    • LVS - large vessel stroke

    • DD - Deltion /Deletion

    • ID - Insertion/Deletion

    • II - Insertion/insertion genotypes

    • TOAST - Trial of ORG 10172 in acute stroke treatment

  • Table 4

    Angiotensin converting enzyme gene polymorphism (ACE) as regards NIHSS in ischemic stroke patients.

    ItemsNIHSS in patients(n=70)Mean±SDTest of significanceP-value
    ACE gene polymorphism:0.226
    DD6.23±2.80ANOVA=1.52P1=0.057
    ID7.13±2.75P2<0.001
    II7.57±1.09P3=0.215
    ACE gene alleles:
    D alleles6.23±2.80t=1.710.095
    I alleles7.57±1.09

    • P1 - DD vs ID

    • P2 - DD vs II

    • P3 - II vs ID

    • ACE - Angiotensin Converting Enzyme

    • DD - Deltion/Deltion genotype

    • ID - Insertion/Deletion genotype

    • II - Insertion/iInsertion genotype

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