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Background: The angiotensin-converting enzyme (ACE) is highly expressed in aneurysmal vascular wall, both in animal models and human disease. Genetic variations in ACE may be crucial in determining the risk of thoracic aortic aneurysm (TAA).

Objective: The aim of this study was to examine the role of ACE insertion/deletion(ACE I/D) polymorphism in the risk of TAA in patients with bicuspid (BAV) or tricuspid aortic valves (TAV).

Methods: From January 2008 to December 2009, we enrolled a group of 206 patients (149 male; age=59.1±14.9 years) who were referred to our Cardiac Surgery Department for TAA, associated with BAV (n=96) and TAV (n=110), and a group of 312 patients (252 male; age=54.6±11.0 years) with angiographically-proven coronary artery disease (CAD). A group of 300 healthy subjects (91 male; age=40.2±10.6 years) was used as control group.

Results: The genotype …