Variant Aldehyde Dehydrogenase 2 (ALDH2*2) Is a Risk Factor for Coronary Spasm and ST-Segment Elevation Myocardial Infarction.
Variant Aldehyde Dehydrogenase 2 (ALDH2*2) Is a Risk Factor for Coronary Spasm and ST-Segment Elevation Myocardial Infarction.
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DOI：
10.1161/jaha.116.003247
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发表时间：
2016-05-06
影响因子：
5.4
通讯作者：
Yasue H
中科院分区：
文献类型：
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作者：
Mizuno Y;Hokimoto S;Harada E;Kinoshita K;Nakagawa K;Yoshimura M;Ogawa H;Yasue H
线粒体醛脱氢酶2（ALDH 2）在清除有毒醛类中起关键作用。ALDH 2 *2基因型缺陷在高达40%的东亚人中普遍存在，并被报道与急性心肌梗死（AMI）相关。为了阐明ALDH 2 *2与AMI相关的机制，我们比较了携带ALDH 2 *2的AMI患者与携带野生型ALDH 2 *1/*1的患者的临床特征。研究受试者包括202例日本急性ST段抬高型心肌梗死（STEMI）患者（156例男性和46例女性;平均年龄67.3±12.0岁），这些患者接受了直接经皮冠状动脉介入治疗（PCI）。在85例患者中，还在PCI后6个月进行了冠状动脉痉挛激发试验。直接应用TaqMan聚合酶链系统进行ALDH 2基因分型。在202例患者中，103例（51.0%）为ALDH 2 *2携带者，99例（49.0%）为ALDH 2 *1/*1携带者。ALDH 2 *2和ALDH 2 *1/*1携带者除冠状动脉痉挛和酒精潮红综合征（AFS）发生率较高外，其他临床特征无差异。（88.6% vs 56.1%; P=0.001和94.3% vs 17.6%; P<0.001），较少饮酒习惯（14.6%对51.5%; P<0.001），并且ALDH 2 *2中的峰值血浆肌酸磷酸激酶水平（2224对1617 mg/dL; P=0.002）高于ALDH 2 *1/*1携带者组。 ALDH 2 *2在日本STEMI患者中普遍存在（51.0%），与ALDH 2 *1/*1患者相比，ALDH 2 *2患者的冠状动脉痉挛和AFS频率更高，心肌损伤更严重。
Mitochondrial aldehyde dehydrogenase 2 (ALDH2) plays a key role in removing toxic aldehydes. Deficient variant ALDH2*2 genotype is prevalent in up to 40% of the East Asians and reported to be associated with acute myocardial infarction (AMI). To elucidate the mechanisms underlying the association of ALDH2*2 with AMI, we compared the clinical features of AMI patients with ALDH2*2 to those with wild‐type ALDH2*1/*1. The study subjects consisted of 202 Japanese patients with acute ST‐segment elevation myocardial infarction (STEMI) (156 men and 46 women; mean age, 67.3±12.0) who underwent primary percutaneous coronary intervention (PCI). In 85 patients, provocation test for coronary spasm was also done 6 month post‐PCI. ALDH2 genotyping was performed by direct application of the TaqMan polymerase chain system. Of the 202 patients, 103 (51.0%) were carriers of ALDH2*2 and 99 (49.0%) those of ALDH2*1/*1. There were no differences in clinical features between ALDH2*2 and ALDH2*1/*1 carrier groups except higher frequencies of coronary spasm and alcohol flush syndrome (AFS) (88.6% vs 56.1%; P=0.001 and 94.3% vs 17.6%; P<0.001), less‐frequent alcohol habit (14.6% vs 51.5%; P<0.001), and higher peak plasma creatine phophokinase levels (2224 vs 1617 mg/dL; P=0.002) in the ALDH2*2 than the ALDH2*1/*1 carrier group. ALDH2*2 is prevalent (51.0%) among Japanese STEMI patients, and those with ALDH2*2 had higher frequencies of coronary spasm and AFS and more‐severe myocardial injury compared to those with ALDH2*1/*1.