Open AccessVariant Aldehyde Dehydrogenase 2 ( ALDH 2*2 ) Is a Risk Factor for Coronary Spasm and ST ‐Segment Elevation Myocardial Infarction
Author(s) -
Mizuno Yuji,
Hokimoto Seiji,
Harada Eisaku,
Kinoshita Kenji,
Nakagawa Kazuko,
Yoshimura Michihiro,
Ogawa Hisao,
Yasue Hirofumi
Publication year - 2016
Publication title -
journal of the american heart association
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.494
H-Index - 85
ISSN - 2047-9980
DOI - 10.1161/jaha.116.003247
Subject(s) - aldehyde dehydrogenase , medicine , aldh2 , myocardial infarction , cardiology , percutaneous coronary intervention , conventional pci , gastroenterology , biochemistry , enzyme , chemistry
Background Mitochondrial aldehyde dehydrogenase 2 ( ALDH 2) plays a key role in removing toxic aldehydes. Deficient variant ALDH 2*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 ALDH 2*2 with AMI , we compared the clinical features of AMI patients with ALDH 2*2 to those with wild‐type ALDH 2*1/*1 . Methods and Results 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 . ALDH 2 genotyping was performed by direct application of the TaqMan polymerase chain system. Of the 202 patients, 103 (51.0%) were carriers of ALDH 2*2 and 99 (49.0%) those of ALDH 2*1/*1 . There were no differences in clinical features between ALDH 2*2 and ALDH 2*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 ALDH 2*2 than the ALDH 2*1/*1 carrier group. Conclusions ALDH 2*2 is prevalent (51.0%) among Japanese STEMI patients, and those with ALDH 2*2 had higher frequencies of coronary spasm and AFS and more‐severe myocardial injury compared to those with ALDH 2*1/*1 .