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Deletion polymorphism in the angiotensin-converting enzyme gene as a thrombophilic risk factor after hip arthroplasty.
Thromb Haemost. 1998 Dec; 80(6):869-73.TH

Abstract

Despite thromboprophylaxis, deep vein thrombosis is a common complication of major orthopedic surgery. Predisposing genetic risk factors are unknown. In this case-control study, we investigated the association of the insertion (I)/deletion (D) angiotensin converting enzyme (ACE) gene polymorphism, Factor V Leiden (R506Q) mutation, and 5,10 methylenetetrahydrofolate reductase (MTHFR) gene polymorphism with post-operative venous thrombosis in 85 patients who underwent elective total hip arthroplasty. The odds of a thrombotic event following hip surgery among subjects with the DD genotype of the ACE gene was increased more than 10-fold compared to subjects with the II genotype (odds ratio 11.7 [95% confidence interval 2.3-84.5]); it was increased 5-fold in subjects with the ID genotype compared to the II genotype (odds ratio 5.0 [95% confidence interval 1.1-34.9]). Mean plasma ACE level in control subjects not on ACE inhibitors at the time of study (n=43) was lowest in persons homozygous for the I allele (18.9+/-7.95 U/l), intermediate in patients with the ID genotype (31.6+/-10.8 U/l) and highest in subjects homozygous for the D allele (44.0+/-7.14 U/l). Mean plasma ACE level among cases was higher (33.0 U/l, n=25) than among controls (29.4 U/l, n=43) but this difference was not statistically significant. Neither the Factor V Leiden mutation nor MTHFR gene polymorphism increased the risk of thrombosis following hip replacement. These results demonstrate that the I/D ACE gene polymorphism is a potent risk factor for thrombosis in subjects undergoing total hip arthroplasty.

Authors+Show Affiliations

Division of Hematology, UMDNJ-Robert Wood Johnson Medical School, New Brunswick, New Jersey 08904, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

9869151

Citation

Philipp, C S., et al. "Deletion Polymorphism in the Angiotensin-converting Enzyme Gene as a Thrombophilic Risk Factor After Hip Arthroplasty." Thrombosis and Haemostasis, vol. 80, no. 6, 1998, pp. 869-73.
Philipp CS, Dilley A, Saidi P, et al. Deletion polymorphism in the angiotensin-converting enzyme gene as a thrombophilic risk factor after hip arthroplasty. Thromb Haemost. 1998;80(6):869-73.
Philipp, C. S., Dilley, A., Saidi, P., Evatt, B., Austin, H., Zawadsky, J., Harwood, D., Ellingsen, D., Barnhart, E., Phillips, D. J., & Hooper, W. C. (1998). Deletion polymorphism in the angiotensin-converting enzyme gene as a thrombophilic risk factor after hip arthroplasty. Thrombosis and Haemostasis, 80(6), 869-73.
Philipp CS, et al. Deletion Polymorphism in the Angiotensin-converting Enzyme Gene as a Thrombophilic Risk Factor After Hip Arthroplasty. Thromb Haemost. 1998;80(6):869-73. PubMed PMID: 9869151.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Deletion polymorphism in the angiotensin-converting enzyme gene as a thrombophilic risk factor after hip arthroplasty. AU - Philipp,C S, AU - Dilley,A, AU - Saidi,P, AU - Evatt,B, AU - Austin,H, AU - Zawadsky,J, AU - Harwood,D, AU - Ellingsen,D, AU - Barnhart,E, AU - Phillips,D J, AU - Hooper,W C, PY - 1998/12/30/pubmed PY - 1998/12/30/medline PY - 1998/12/30/entrez SP - 869 EP - 73 JF - Thrombosis and haemostasis JO - Thromb Haemost VL - 80 IS - 6 N2 - Despite thromboprophylaxis, deep vein thrombosis is a common complication of major orthopedic surgery. Predisposing genetic risk factors are unknown. In this case-control study, we investigated the association of the insertion (I)/deletion (D) angiotensin converting enzyme (ACE) gene polymorphism, Factor V Leiden (R506Q) mutation, and 5,10 methylenetetrahydrofolate reductase (MTHFR) gene polymorphism with post-operative venous thrombosis in 85 patients who underwent elective total hip arthroplasty. The odds of a thrombotic event following hip surgery among subjects with the DD genotype of the ACE gene was increased more than 10-fold compared to subjects with the II genotype (odds ratio 11.7 [95% confidence interval 2.3-84.5]); it was increased 5-fold in subjects with the ID genotype compared to the II genotype (odds ratio 5.0 [95% confidence interval 1.1-34.9]). Mean plasma ACE level in control subjects not on ACE inhibitors at the time of study (n=43) was lowest in persons homozygous for the I allele (18.9+/-7.95 U/l), intermediate in patients with the ID genotype (31.6+/-10.8 U/l) and highest in subjects homozygous for the D allele (44.0+/-7.14 U/l). Mean plasma ACE level among cases was higher (33.0 U/l, n=25) than among controls (29.4 U/l, n=43) but this difference was not statistically significant. Neither the Factor V Leiden mutation nor MTHFR gene polymorphism increased the risk of thrombosis following hip replacement. These results demonstrate that the I/D ACE gene polymorphism is a potent risk factor for thrombosis in subjects undergoing total hip arthroplasty. SN - 0340-6245 UR - https://www.unboundmedicine.com/medline/citation/9869151/Deletion_polymorphism_in_the_angiotensin_converting_enzyme_gene_as_a_thrombophilic_risk_factor_after_hip_arthroplasty_ L2 - https://medlineplus.gov/pulmonaryembolism.html DB - PRIME DP - Unbound Medicine ER -