Variant Aldehyde Dehydrogenase 2 (ALDH2*2) Is a Risk Factor for Coronary Spasm and ST-Segment Elevation Myocardial Infarction

Background: mitochondrial aldehyde dehydrogenase 2 (aldh2) plays a key role in removing toxic aldehydes. deficient variant aldh*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. © 2016 the authors. published on behalf of the american heart association,inc.,by wiley blackwell.