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ACE Genotyping for Coronary Risk Assessment

Angiotensin I Converting Enzyme Polymorphism Analysis, ACE Genotyping

Test Codes

EPIC: LAB6373, Beaker: GACEG

Department

Molecular Pathology

Instructions

This test is available to outpatients only and should only be ordered once in a lifetime.

For questions, please call 800-551-0488.

Specimen Collection Criteria

Collect: One 4.0 mL whole blood in Lavender-top EDTA tube. (Minimum: 4.0 mL)

Physician Office/Draw Specimen Preparation

Do not freeze specimens. Maintain whole blood refrigerated (preferred) (2-8°C or 36-46°F) or at room temperature (20-26°C or 68-78.8°F) prior to transport.

Preparation for Courier Transport

Transport: Whole blood refrigerated (preferred) (2-8°C or 36-46°F) or at room temperature (20-25°C or 68-77°F). (Minimum: 4.0 mL whole blood)

Rejection Criteria

• Frozen specimens.
• Centrifuged specimens. 
• Mislabeled or unlabeled tubes. 
• Specimens collected in heparin tubes (Green-top), clot tubes (Red-top), or SST tubes.
• Specimens not collected and processed as indicated.
• This test will only be performed once in a lifetime for a patient.
• Client will be notified of any cancellation of testing.

In-Lab Processing

Do not freeze specimens. Maintain specimen refrigerated (2-8°C or 36-46°F) prior to testing.

Storage

Specimen Stability for Testing:

Whole Blood
Room Temperature (20-26°C or 68-78.8°F): 72 hours
Refrigerated (2-8°C or 36-46°F): 7 days
Frozen (-20°C/-4°F or below): Unacceptable


Specimen Storage in Department Prior to Disposal:

Refrigerated (2-8°C or 36-46°F): 14 days

Extracted DNA may be available for additional testing if clinically indicated. Contact the Molecular Pathology Laboratory for verification.

Laboratory

Royal Oak Clinical Molecular Pathology Laboratory

Performed

Once per week.
Results available in 7-10 days.

Reference Range

Wild type; II genotype.

Test Methodology

PCR (Polymerase Chain Reaction) followed by Agarose Gel Electrophoresis.

Interpretation

• The test detects the Insertion/Deletion (I/D) polymorphism in the angiotensin-converting enzyme (ACE) gene.
• The DD genotype is associated with elevated plasma ACE levels (twice higher than II genotype).
• ID heterozygotes have intermediate ACE plasma levels.
• The DD genotype is associated with increased risk for coronary artery disease, myocardial infarction, coronary restenosis after stent implantation and thrombotic events post-surgery.

Clinical Utility

• This test assists in the risk assessment for coronary artery disease. Genetic predisposition for cardiovascular disease appears to be the end result of cumulative effects of multiple genetic polymorphisms, which would confer only modestly increased risk when present as a single genetic risk factor. Therefore, testing for multiple genotypes with known synergistic effects, including ACE is suggested.
• Testing for ACE Genotyping is recommended for:
  • Risk assessment for coronary artery disease and essential hypertension in patients with positive family history.
  • Assessment of risk for recurrent coronary events and coronary restenosis after stent implantation.
  • Therapy management (ACE inhibitors, angiotensin receptor inhibitors) in patients with hypertension and positivity for ACE, gene polymorphisms. 

CPT Codes

81400

Contacts

Last Updated

10/30/2023