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Background  The association of the deletion in GSTT1 and GSTM1 genes with coronary artery disease (CAD) among smokers is controversial. In addition, no such investigation has previously been conducted among Arabs.    Methods  We genotyped 1054 CAD patients and 762 controls for GSTT1 and GSTM1 deletion by multiplex polymerase chain reaction. Both CAD and controls were Saudi Arabs.    Results  In the control group (n = 762), 82.3% had the T  wild  M  wild genotype, 9% had the T wild  M  null , 2.4% had the T null  M  wild  and 6.3% had the T null  M  null  genotype. Among the CAD group (n = 1054), 29.5% had the T wild  M  wild  genotype, 26.6% (p < .001) had the T wild  M  null , 8.3% (p < .001) had the T null  M  wild  and 35.6% (p < .001) had the T null  M  null  genotype, indicating a significant association of the T wild  M  null , T null  M  wild  and T null  M  null  genotypes with CAD. Univariate analysis also showed that smoking, age, hypercholesterolemia and hypertriglyceridemia, diabetes mellitus, family history of CAD, hypertension and obesity are all associated with CAD, whereas gender and myocardial infarction are not. Binary logistic regression for smoking and genotypes indicated that only M  null  and T null are interacting with smoking. However, further subgroup analysis stratifying the data by smoking status suggested that genotype-smoking interactions have no effect on the development of CAD.    Conclusion  GSTT1 and GSTM1 null-genotypes are risk factor for CAD independent of genotype-smoking interaction.

T null and M nullgenotypes of the glutathione S-transferase gene are risk factor for CAD independent of smoking