Nitroglycerin May Be Less Effective in Asian Patients

FRIDAY, Jan. 27 (HealthDay News) Mutations in the aldehyde dehydrogenase-2 (ALDH2) gene that are particularly common in Asian populations can significantly reduce the effectiveness of sublingual nitroglycerin, according to a study published online Jan. 26 in the Journal of Clinical Investigation. Li Jin, Ph.D., of Fudan University in Shanghai, China, and colleagues compared genotypes in 80 coronary heart disease patients, 59 of whom responded to self-administered sublingual nitroglycerin (glyceryl trinitrate, or GTN) during acute angina attacks and 21 of whom did not. The efficacy rate of GTN was significantly higher in the ALDH2*1/1 homozygotes (40 out of 47, or 85.1%) than in patients carrying at least one ALDH2*2 allele (19 out of 33, or 57.6%). This suggests that patients with the common G-to-A polymorphism in exon 12 of ALDH2 gene may be less likely to respond to GTN. The researchers recommend "that this genetic factor be considered when administering nitroglycerin to patients, especially Asians, 30% to 50% of whom possess the inactive ALDH2*2 mutant allele," the authors conclude. "In addition to a DNA test, it is well known that the 'flushing response' to alcohol is an indicator of the ALDH2*2 allele. Thus, this test may be a convenient and conservative alternative for the practicing physician in predicting sublingual GTN efficacy if the DNA test is not readily available."
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Rick Ansorge
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