Clinical and Genetic Features of the Developmentof Complications of Acute Myocardial Infarction
Purpose of the study was to study the angiotensin-converting enzyme (ACE) gene associations with the clinical picture of the most frequent complications of acute myocardial infarction (MI). The study included 190 patients who underwent one or more MI included in the WHO's “Register of Acute Myocardial Infarction.” All the patients underwent genetic research on the determination of allelic variants of the ACE gene (polymorphism I/D). It was found that the DD genotype of the ACE gene is associated with a more frequent occurrence of acute left ventricular aneurysm (ALVA) (OR = 2.46, 95% CI 1.08–5.63, p = 0.037, χ2 = 4.73). In the group of patients with acute left ventricular failure (ALVF) the picture looked otherwise: the genotype II of the ACE gene was more frequent (OR = 2.86, 95% CI 1.35–6.08, p = 0.007, χ2 = 7.81). Patients in the group without ALVF were carries of the allele D more often (77.1%) (p = 0.007, χ2 = 7.81). Discovered genetic associations contribute to the consideration of the ACE gene as a genetic predictor of the development of ALVA in the acute period of MI. Further study of this gene in combination with other genetic markers of MI, as well as analysis of distribution of the genotypes of the ACE gene among the deceased patients who underwent MI, will allow us to understand the genetic mechanisms of the development of other complications of MI, in particular ALVF. All this will ensure the development of new highly effective personalized approaches to the prevention and treatment of complications of acute MI and the improvement of immediate and remote prognosis of patients.