Genetic Determinants of Myocardial Infarction

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Abstract
A family history of myocardial infarction (MI), especially MI at an early age, is a potent risk factor for coronary artery disease (CAD). The risk increases with the number of first-degree relatives affected and is inversely related to the age at which they became affected (Roncaglioni et al., 1992). While some of this increased risk is due to shared environment, genetic factors appear to predominate (Nora et al., 1980). Monozygotic (identical) twins are significantly more likely to be concordant for CAD than are dizygotic (fraternal) twins (Goldbourt and Neufeld, 1986). Dyslipidemia, diabetes mellitus, hypertension and obesity, the major metabolic risk factors for CAD, are in large measure genetically determined. In addition, a family history of MI confers increased risk in both genders independent of other known risk factors (Colditz et al., 1991; Roncaglioni et al., 1992).