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  Vol. 295 No. 7, February 15, 2006 TABLE OF CONTENTS
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beta2-Adrenergic Receptor Genotype and Survival After Acute Coronary Syndrome

Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

To the Editor: The study by Dr Lanfear and colleagues1 showed an apparent disconnect between the effects that ADRB2 and ADRB1 variants have on survival in patients receiving beta-blockers after an acute coronary syndrome. The homozygous composite genotypes comprising Arg-Arg16 /Gln-Gln 27 (46AA/79CC) and Gly-Gly16/Glu-Glu 27 (46GG/79GG) were associated with a higher and lower risk of death, respectively, amounting to a 14% difference in mortality rate over 3 years.

The acute fall in serum potassium level and diastolic blood pressure in response to ADRB2 stimulation by albuterol is significantly greater in patients with genotype 46AA/79CC compared with 46GG/79GG.2 This suggests the possibility of a genetic susceptibility to the ADRB2-mediated adverse effects of raised levels of endogenous circulating epinephrine in the high-risk group when treated with beta-blockers.

The authors did not state which beta-blockers were used in the study. This is relevant because the more commonly used beta1-selective blockers might . . . [Full Text of this Article]

Catherine M. Jackson, MD
Tayside Centre for General Practice

Brian J. Lipworth, MD
b.j.lipworth@dundee.ac.uk
Division of Medicine and Clinical Pharmacology
Ninewells Hospital and Medical School
Dundee, Scotland



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