ORIGINAL ARTICLESPrognostic impact of carboxylesterase 1 gene variants in patients with congestive heart failure treated with angiotensin-converting enzyme inhibitorsNelveg-Kristensen, Karl E.; Madsen, Majbritt B.; Torp-Pedersen, Christian; Køber, Lars; Egfjord, Martin; Hansen, Torben; Pedersen, Oluf; Rasmussen, Henrik B.; Hansen, Peter R.Author Information aDepartment of Cardiology, Gentofte University Hospital, Hellerup bInstitute of Biological Psychiatry, Mental Health Centre Sct. Hans, Copenhagen University Hospital, Roskilde cThe Heart Centre, Rigshospitalet, Copenhagen University Hospital dDepartment of Nephrology, Rigshospitalet, Copenhagen University Hospital eThe Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen fInstitute of Health, Science and Technology, Aalborg University, Aalborg, Denmark Correspondence to Karl E. Nelveg-Kristensen, MD, Department of Cardiology, post 635, Gentofte University Hospital, Niels Andersens Vej 65, DK-2900 Hellerup, Denmark Tel: +45 39 978 717; fax: +45 70 201 283; e-mail: email@example.com Received July 24, 2015 Accepted December 22, 2015 Pharmacogenetics and Genomics: April 2016 - Volume 26 - Issue 4 - p 169-177 doi: 10.1097/FPC.0000000000000203 Buy Metrics Abstract Objective Most angiotensin-converting enzyme inhibitors (ACEIs) are prodrugs activated by carboxylesterase 1 (CES1). We investigated the prognostic importance of CES1 gene (CES1) copy number variation and the rs3815583 single-nucleotide polymorphism in CES1 among ACEI-treated patients with congestive heart failure (CHF). Methods Danish patients with chronic CHF enrolled in the previously reported Echocardiography and Heart Outcome Study were categorized according to their CES1 variants and followed up for up to 10 years. Risk for cardiovascular death and all-cause death was modeled by Cox proportional hazard analyses. Results A total of 491 ACEI-treated patients were included in the analyses. After a mean follow-up of 5.5 years, we found no difference in the risk for cardiovascular death and all-cause death between patients having three [hazard ratios (HRs) 1.06 (95% confidence interval (CI) 0.77–1.45) and 1.16 (95% CI 0.88–1.52)] or four [HRs 0.88 (95% CI 0.39–2.01) and 1.37 (95% CI 0.74–2.54)] CES1 copies and those with two copies, respectively. Similarly, no difference in the risk for cardiovascular and all-cause death was found for patients heterozygous [HRs 0.91 (95% CI 0.70–1.19) and 0.88 (95% CI 0.69–1.12)] or homozygous [HRs 0.58 (95% CI 0.30–1.15) and 0.82 (95% CI 0.48–1.39)] for the rs3815583 minor allele versus patients homozygous for the major allele. The active promoter of CES1A2 and the rs71647871 single-nucleotide polymorphism minor allele were detected at very low frequencies. Conclusion This study did not support the use of CES1 copy number variation or rs3815583 as a predictor of fatal outcomes in ACEI-treated patients with CHF. Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.