Association Between Angiotensin Converting Enzyme I/D Polymorphism And In-stent Restenosis After PCI:a Meta-analysis

Purpose:The aim of this meta-analysis was to assess the relationship between the ACE I/D polymorphism and in-stent restenosis(ISR)in patients after PCI,and guide the clinical treatment of coronary heart disease(CHD).Methods:All case-control studies up date to March 2018 on the relationship between the ACE I/D polymorphism and ISR were identified by retrieving CNKI,Wanfang database,EMBASE and PubMed databases.Newcastle-Ottawa Scale(NOS)quality score was conducted.The meta-analysis was conducted using Stata12.0software for the collected data.The association between ACE I/D polymorphism and ISR was estimated by odds ratios(ORs)with 95%confidence intervals(95%CIs).In addition,the Q test and the I~2 test were conducted to analyze heterogeneity between the studies,and the random effect model was applied to analyze the data when the heterogeneity was large,the fixed effect model was applied otherwise.Begg's funnel plot and Egger's test were performed to detect the publication bias of the studies.Sensitivity analyses were conducted to evaluate the primary origin of the heterogeneity by remove a study in order.Results:A total of 6 studies were collected in our meta-analysis based on the inclusion and exclusion criteria,two of which were about Asian and four were about Caucasian.The total sample size was 1137,ISR group 314 cases.Overall,DD+DI genotype of ACE I/D could reduce the risk of ISR[DD+DI vs.II:P=0.038,OR=0.63(0.40,0.97)].In subgroup analysis,DD genotype of ACE I/D could reduce the risk of ISR in the Caucasian[DD vs.II+ID:P=0.016,OR=2.67(1.20,5.96)].None of the four genetic models was proved to be related to IRS risk in Asian.Conclusion:ACE I/D gene polymorphism is associated with in-stent restenosis after PCI,and DD genotype of ACE I/D can reduce the risk of ISR of the Caucasian.