The impact of polymorphism of angiotensin converting enzyme gene I/D on atrial fibrillation: A Meta- analysis

Pi Yang; Qian Cheng; Wei Baozhu; Cao Jianlei; Feng Hong; Wang Yanggan

doi:10.3969/j.issn.1674-4055.2017.08.02

Abstract：Objective To evaluate the impact of angiotensin converting enzyme (ACE) I/D polymorphism on the risk of atrial fibrillation (AF).Methods Eligible studies about the impact of ACE I/D polymorphism on the risk of atrial fibrillation were searched in PubMed, Web of Science, Google Scholar, CNKI and Wanfang from when the databases established to 2016.3. STATA 12.0 is used to statistically analyze the relevant articles. The associations between ACE I/D polymorphism and AF risk were estimated by pooled odds ratio (OR) and 95％ confidence interval (CI) using a fixed or random-effects model. Publication bias was also calculated. Subgroup analysis and sensitivity analysis are used to find the possible source of heterogeneity. And subgroup analyses are conducted with respect to ethnicity, AF type and age.Results A total of 20 studies which evaluated the association between ACE I/D polymorphisms and AF were included, with 3006 cases and 4861 controls. The pooled OR was 1.22 (95％CI:0.97～1.52) for dominant model, 1.22 (95％CI: 1.04～1.43) for allele model, 1.41 (95％CI: 1.11～1.98) for recessive model, 1.48 (95％CI: 1.11～1.98) for additive model, 1.36 (DDvs. DI, 95％CI: 1.09～1.70) and 1.12 (DIvs. II, 95％CI: 0.89 to 1.39) for codominant gene model, respectively. In subgroup analysis, a strong association was found in Caucasians in recessive model (OR=1.53, 95％CI: 1.09～2.95). Strong associations were also found in hypertensive patients of all five models and subjects ≥ 65-year-old of recessive model and co-dominant model. No publication bias was found in this study.Conclusion ACE I / D polymorphism is an important risk factor for the onset of atrial fibrillation. DD genotype significantly increases the risk of atrial fibrillation, especially in the Caucasus and hypertensive patients. Meanwhile, DD genotype significantly increase AF risk in patients over 65 years old, but no association was observed in patients below 65 years old.