Association between Genetic Polymorphisms in the Renin-Angiotensin System and Systolic Heart Failure Revised by a Propensity Score-Based Analysis

Objectives: The objective of this study is to identify possible genetic polymorphisms of the renin-angiotensin system (RAS) in systolic heart failure (sHF). Methods: A total of 509 patients were enrolled into this study. A non-parsimonious multivariable logistic regression model that incorporated potential risk factors was applied to calculate the propensity score for developing sHF. A 1: 1 case-control selection process was made according to the rank of propensity. The six genetic polymorphisms of angiotensinogen (AGT), including T174M, M235T, G-6A, A-20C, G-152A, and G-217A, and angiotensin-converting enzyme (ACE) gene I/D polymorphism were typed by polymerase chain reaction and DNA sequencing technique. Results: The CC genotype at T174M was positively associated with sHF (OR 2.81, 95% CI 1.20-6.61, p = 0.018). The GG genotype at G-152A was also positively associated with the presence of sHF (OR 6.25, 95% CI 1.54-25.4, p = 0.010). OR of the ACE DD genotype for sHF, as compared with ACE II genotype, was 1.37 (p = 0.475), and OR for ID genotype compared with II genotype was 5.95 for sHF (95% CI 2.16-16.4, p = 0.001). Conclusions: The exploration of these RAS genes related to sHF may provide a more targeted and tailored treatment of sHF. Copyright (C) 2010 S. Karger AG, Basel