Variant Aldehyde Dehydrogenase 2 (ALDH22) Is a Risk Factor for Coronary Spasm and ST‐Segment Elevation Myocardial Infarction

• Published in: Journal of the American Heart Association Vol. 5; no. 5
• Main Authors: Mizuno, Yuji, Hokimoto, Seiji, Harada, Eisaku, Kinoshita, Kenji, Nakagawa, Kazuko, Yoshimura, Michihiro, Ogawa, Hisao, Yasue, Hirofumi
• Format: Journal Article
• Language: English
• Published: England John Wiley and Sons Inc 06.05.2016; Wiley
• Subjects: acute myocardial infarction; Aged; alcohol flushing syndrome; aldehyde dehydrogenase 2; Aldehyde Dehydrogenase, Mitochondrial - genetics; Asian Continental Ancestry Group; Central Nervous System Depressants - adverse effects; coronary spasm; coronary spastic angina; Coronary Vasospasm - genetics; Creatine Kinase - blood; Ethanol - adverse effects; Female; Flushing - chemically induced; Flushing - genetics; Genetic Predisposition to Disease; Genetic Variation; Genotype; Humans; Japan; Male; Middle Aged; Original Research; Percutaneous Coronary Intervention; Risk Factors; Severity of Illness Index; ST Elevation Myocardial Infarction - blood; ST Elevation Myocardial Infarction - genetics; ST Elevation Myocardial Infarction - surgery; Troponin T - blood; alcohol flushing syndrome; aldehyde dehydrogenase 2; coronary spasm; coronary spastic angina; acute myocardial infarction
• ISSN: 2047-9980; 2047-9980
• DOI: 10.1161/JAHA.116.003247

Background Mitochondrial aldehyde dehydrogenase 2 (ALDH2) plays a key role in removing toxic aldehydes. Deficient variant ALDH2*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 ALDH2*2 with AMI, we compared the clinical features of AMI patients with ALDH2*2 to those with wild‐type ALDH2*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. ALDH2 genotyping was performed by direct application of the TaqMan polymerase chain system. Of the 202 patients, 103 (51.0%) were carriers of ALDH2*2 and 99 (49.0%) those of ALDH2*1/*1. There were no differences in clinical features between ALDH2*2 and ALDH2*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 ALDH2*2 than the ALDH2*1/*1 carrier group. Conclusions ALDH2*2 is prevalent (51.0%) among Japanese STEMI patients, and those with ALDH2*2 had higher frequencies of coronary spasm and AFS and more‐severe myocardial injury compared to those with ALDH2*1/*1.