Nitroglycerin, also called glyceryl trinitrate (GTN), has been widely used for the management of coronary heart disease, specifically angina and heart failure, for more than 130 years. The efficacy of GTN is determined by the ability of the body to convert it to nitric oxide (NO), a process that requires the enzyme mitochondrial aldehyde dehydrogenase-2 (ALDH2).
Li Jin and colleagues at Fudan University in China now show that the reason some Asians have trouble responding to GTN is that 30-50% of this population possess an inactive mutant form of the gene known as ALDH2*2.
The study, which appears online on January 26 in advance of print publication in the February 2006 issue of the Journal of Clinical Investigation, examined a total of 111 Chinese coronary heart disease patients who were self-administering GTN under the tongue during acute attacks of angina. Eighty subjects (72%) reported pain relief that occurred in less than 10 minutes (responders) and the remainder had no pain relief (nonresponders).
The authors determined that the nonresponders tended to have the ALDH2*2 form of the gene, and they suggest that this genetic factor may warrant consideration when administering nitroglycerin to Asian patients.
TITLE: Mitochondrial aldehyde dehydrogenase-2 (ALDH2) Glu504Lys polymorphism contributes to the variation in efficacy of sublingual nitroglycerin
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