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Title: Plasma Angiotensin Converting Enzyme 2 (ACE2) Activity in Healthy Controls and Patients with Cardiovascular Risk Factors and/or Disease.
Austin Authors: Lim, Hui Yin;Patel, Sheila K ;Huang, Ping;Tacey, Mark A ;Choy, Kay Weng;Wang, Julie;Donnan, Geoffrey A ;Nandurkar, Harshal H;Ho, Prahlad;Burrell, Louise M 
Affiliation: The Melbourne Brain Centre, Royal Melbourne Hospital, University of Melbourne, Parkville, VIC 3052,Australia
Northern Pathology Victoria, Northern Health, Epping, Melbourne, VIC 3076,Australia
Department of Medicine, Northern Health, University of Melbourne, Epping, Melbourne, VIC 3076,Australia
General Medicine
Australian Centre for Blood Diseases, Monash University, Melbourne VIC 3004,Australia
The Northern Hospital, Epping, VIC 3076,Australia
Department of Medicine & Radiology, University of Melbourne, Parkville, VIC 3052,Australia
Issue Date: 13-Sep-2022
Date: 2022
Publication information: Journal of Personalized medicine 2022; 12(9)
Abstract: Angiotensin converting enzyme 2 (ACE2) is an endogenous negative regulator of the renin-angiotensin system, a key factor in the development of cardiovascular disease (CVD). ACE2 is also used by SARS-CoV-2 for host cell entry. Given that COVID-19 is associated with hypercoagulability, it is timely to explore the potential relationship between plasma ACE2 activity and the coagulation profile. In this cross-sectional study, ACE2 activity and global coagulation assays (GCA) including thromboelastography, thrombin, and fibrin generation were measured in adult healthy controls (n = 123; mean age 41 ± 17 years; 35% male) and in patients with cardiovascular risk factors and/or disease (n = 258; mean age 65 ± 14 years; 55% male). ACE2 activity was significantly lower in controls compared to patients with cardiovascular risk factors and/or disease (median 0.10 (0.02, 3.33) vs. 5.99 (1.95, 10.37) pmol/mL/min, p < 0.001). Of the healthy controls, 48% had undetectable ACE2 activity. Controls with detectable ACE2 had lower maximum amplitude (p < 0.001). In patients with cardiovascular risk factors and/or disease, those in the 3rd tertile were older and male (p = 0.002), with a higher Framingham grade and increased number of cardiovascular risk factors (p < 0.001). In conclusion, plasma ACE2 activity is undetectable to very low in young healthy controls with minimal clinically relevant associations to GCA. Patients with cardiovascular risk factors and/or disease have increased plasma ACE2 activity, suggesting that it may be an important biomarker of endothelial dysfunction and atherosclerosis.
DOI: 10.3390/jpm12091495
ORCID: 0000-0003-2455-3155
Journal: Journal of Personalized Medicine
PubMed URL: 36143280
ISSN: 2075-4426
Type: Journal Article
Subjects: angiotensin converting enzyme 2
cardiovascular disease
renin angiotensin system
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