{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T06:30:47Z","timestamp":1791181847430,"version":"4.1.0"},"reference-count":19,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[1995,8]]},"abstract":"<jats:p>\n            <jats:italic>Background and Purpose<\/jats:italic>\n            A deletion (\n            <jats:italic>D<\/jats:italic>\n            )\/insertion (\n            <jats:italic>I<\/jats:italic>\n            ) polymorphism in the angiotensin-converting enzyme gene has been associated with myocardial infarction. Its relations to both stroke and atheroma remain uncertain. We examined its role as a risk factor in patients with cerebrovascular disease and its relation to carotid atheroma.\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Methods<\/jats:italic>\n            One hundred one patients with symptomatic carotid artery territory cerebral ischemia were compared with 137 age-matched control subjects. In the patient group, carotid atheroma was assessed by measurement of degree of carotid stenosis and intima-media thickness with high-resolution duplex ultrasound. The\n            <jats:italic>D\/I<\/jats:italic>\n            polymorphism was examined using the polymerase chain reaction.\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Results<\/jats:italic>\n            <jats:italic>D:I<\/jats:italic>\n            allele frequency was 0.59:0.41 in case subjects and 0.48:0.52 in control subjects (\n            <jats:italic>P<\/jats:italic>\n            =.01). The\n            <jats:italic>DD<\/jats:italic>\n            genotype was more common in patients with cerebrovascular disease compared with control subjects (36\/101 versus 30\/137,\n            <jats:italic>P<\/jats:italic>\n            =.02). The\n            <jats:italic>DD<\/jats:italic>\n            genotype conferred a relative risk of any type of cerebrovascular disease of 1.98 (95% confidence interval [CI], 1.11 to 3.51;\n            <jats:italic>P<\/jats:italic>\n            =.02). However, this was largely due to a strong association in the 18 patients with lacunar stroke, in whom the\n            <jats:italic>D:I<\/jats:italic>\n            ratio was 0.75:0.25 (\n            <jats:italic>P<\/jats:italic>\n            =.0097 versus control subjects). The odds ratio for lacunar stroke associated with the\n            <jats:italic>DD<\/jats:italic>\n            genotype was 5.6 (95% CI, 2.0 to 15.7) and was still significant at 4.40 (95% CI, 1.45 to 12.6;\n            <jats:italic>P<\/jats:italic>\n            &lt;.009) after controlling for other risk factors. There was no significant association between angiotensin-converting enzyme genotype and cerebrovascular disease due to large-vessel stenosis. There was no association between genotype and age, sex, smoking history, diabetes, or cholesterol level.\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Conclusions<\/jats:italic>\n            The deletion polymorphism in the angiotensin-converting enzyme gene is a new independent risk factor for lacunar stroke but is not a risk factor for stroke associated with carotid stenosis.\n          <\/jats:p>","DOI":"10.1161\/01.str.26.8.1329","type":"journal-article","created":{"date-parts":[[2011,6,17]],"date-time":"2011-06-17T20:08:03Z","timestamp":1308341283000},"page":"1329-1333","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":112,"title":["Angiotensin-Converting Enzyme Gene Deletion Polymorphism"],"prefix":"10.1161","volume":"26","author":[{"given":"Hugh S.","family":"Markus","sequence":"first","affiliation":[{"name":"From the University Department of Neurology, King\u2019s College School of Medicine and Dentistry (H.S.M.), and the Divisions of Clinical Neuroscience (H.S.M., M.M.B.), Medical Genetics (J.B., S.J., N.D.C.), Clinical Chemistry (R.L.), and Public Health Sciences (J.M.B.), St George\u2019s Hospital Medical School, London, UK."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jackie","family":"Barley","sequence":"additional","affiliation":[{"name":"From the University Department of Neurology, King\u2019s College School of Medicine and Dentistry (H.S.M.), and the Divisions of Clinical Neuroscience (H.S.M., M.M.B.), Medical Genetics (J.B., S.J., N.D.C.), Clinical Chemistry (R.L.), and Public Health Sciences (J.M.B.), St George\u2019s Hospital Medical School, London, UK."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ros","family":"Lunt","sequence":"additional","affiliation":[{"name":"From the University Department of Neurology, King\u2019s College School of Medicine and Dentistry (H.S.M.), and the Divisions of Clinical Neuroscience (H.S.M., M.M.B.), Medical Genetics (J.B., S.J., N.D.C.), Clinical Chemistry (R.L.), and Public Health Sciences (J.M.B.), St George\u2019s Hospital Medical School, London, UK."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. Martin","family":"Bland","sequence":"additional","affiliation":[{"name":"From the University Department of Neurology, King\u2019s College School of Medicine and Dentistry (H.S.M.), and the Divisions of Clinical Neuroscience (H.S.M., M.M.B.), Medical Genetics (J.B., S.J., N.D.C.), Clinical Chemistry (R.L.), and Public Health Sciences (J.M.B.), St George\u2019s Hospital Medical School, London, UK."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steve","family":"Jeffery","sequence":"additional","affiliation":[{"name":"From the University Department of Neurology, King\u2019s College School of Medicine and Dentistry (H.S.M.), and the Divisions of Clinical Neuroscience (H.S.M., M.M.B.), Medical Genetics (J.B., S.J., N.D.C.), Clinical Chemistry (R.L.), and Public Health Sciences (J.M.B.), St George\u2019s Hospital Medical School, London, UK."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nick D.","family":"Carter","sequence":"additional","affiliation":[{"name":"From the University Department of Neurology, King\u2019s College School of Medicine and Dentistry (H.S.M.), and the Divisions of Clinical Neuroscience (H.S.M., M.M.B.), Medical Genetics (J.B., S.J., N.D.C.), Clinical Chemistry (R.L.), and Public Health Sciences (J.M.B.), St George\u2019s Hospital Medical School, London, UK."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin M.","family":"Brown","sequence":"additional","affiliation":[{"name":"From the University Department of Neurology, King\u2019s College School of Medicine and Dentistry (H.S.M.), and the Divisions of Clinical Neuroscience (H.S.M., M.M.B.), Medical Genetics (J.B., S.J., N.D.C.), Clinical Chemistry (R.L.), and Public Health Sciences (J.M.B.), St George\u2019s Hospital Medical School, London, UK."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_1_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.23.2.1561651"},{"key":"e_1_3_2_2_2","first-page":"197","volume":"51","year":"1992","unstructured":"Tiret L, Rigat B, Visvikis S, Breda C, Corvol P, Cambien F, Soubrier F. Evidence, from combined segregation and linkage analysis, that a variant of the angiotensin I-converting enzyme (ACE) gene controls plasma ACE levels. Am J Hum Genet. 1992;51:197-205.","journal-title":"Am J Hum Genet"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1038\/359641a0"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1291\/hypres.17.55"},{"key":"e_1_3_2_5_2","first-page":"635","volume":"8","year":"1994","unstructured":"Leatham E, Barley J, Redwood S, Hussein W, Carter N, Jeffery S, Bath PMW, Camm A. Angiotensin-1 converting enzyme (ACE) polymorphism in patients presenting with myocardial infarction or unstable angina. J Hum Hypertens. 1994;8:635-638.","journal-title":"J Hum Hypertens"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/0140-6736(93)92061-W"},{"key":"e_1_3_2_7_2","first-page":"645","volume":"8","year":"1994","unstructured":"Sharma P, Carter ND, Barley J, Brown MM. Molecular approach to assessing the genetic risk of cerebral infarction: deletion polymorphism in the gene encoding angiotensin 1-converting enzyme. J Hum Hypertens. 1994;8:645-648.","journal-title":"J Hum Hypertens"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/atv91.14.2.8305407"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/atv91.14.2.8305418"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/atv91.13.10.8399076"},{"key":"e_1_3_2_11_2","first-page":"955","volume":"12","year":"1994","unstructured":"Barley J, Blackwood A, Carter ND, Crews DE, Cruickshank JK, Jeffery S, Ogunlesi AO, Sagnella GA. Angiotensin converting enzyme insertion\/deletion polymorphism: association with ethnic origin. J Hypertens. 1994;12:955-957.","journal-title":"J Hypertens"},{"key":"e_1_3_2_12_2","unstructured":"Pullicino PM Caplan LR Hommel M eds. Cerebral Small Artery Disease. New York NY: Raven Press Publishers; 1993."},{"key":"e_1_3_2_13_2","unstructured":"Williams MA Deacon DFS Szendro G Balcaro G Nicolaides AN. Duplex scanning in the detection and grading of internal carotid artery stenosis: improved criteria. In: Salmasi A-M Nicolaides AN eds. Cardiovascular Applications of Doppler Ultrasound. Edinburgh Scotland: Churchill Livingstone Inc; 1989:247."},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/0741-5214(93)90116-4"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1172\/JCI117423"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.hyp.21.4.455"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1038\/ng0492-72"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/0006-291X(92)91150-O"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199406093302302"}],"container-title":["Stroke"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/01.STR.26.8.1329","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,12]],"date-time":"2024-05-12T22:34:46Z","timestamp":1715553286000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/01.STR.26.8.1329"}},"subtitle":["A New Risk Factor for Lacunar Stroke but not Carotid Atheroma"],"short-title":[],"issued":{"date-parts":[[1995,8]]},"references-count":19,"journal-issue":{"issue":"8","published-print":{"date-parts":[[1995,8]]}},"alternative-id":["10.1161\/01.STR.26.8.1329"],"URL":"https:\/\/doi.org\/10.1161\/01.str.26.8.1329","relation":{},"ISSN":["0039-2499","1524-4628"],"issn-type":[{"value":"0039-2499","type":"print"},{"value":"1524-4628","type":"electronic"}],"subject":[],"published":{"date-parts":[[1995,8]]},"assertion":[{"value":"1995-03-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"1995-05-05","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"1995-08-01","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}