Genetic--epidemiologic study of early-onset ischemic heart disease.
A genetic-epidemiologic study was undertaken of a white Colorado population of 207 patients who had a myocardial infarction before age 55 years. Nineteen independent variables were compared between the 207 cases and 621 controls, matched 3:1. The highest risk ratios were associated with a positive family history for ischemic heart disease (IHD). The heritability of IHD was 63% when families with the monogenic forms of hyperlipoproteinemia were included, and 56% when they were excluded. A risk index was developed that incorporates family history into a data base of risk factors, which can be readily assessed by the clinician obtaining a screening history, physical and standard laboratory tests. A scale of 0-10 was devised and the predictive value of the index was tested against another data set. The efficiency of the index was maximal at a screening level of 5. This study suggests that it is logistically feasible to seek patients at high risk for intensive management in a clinical setting (high-risk strategy) using risk indices similar to the one developed for this study, which emphasize the very important familial component to IHD.
D000328:Adult; D000367:Age Factors; D002784:Cholesterol / Q000097:blood; D003327:Coronary Disease / Q000097:blood / Q000235:genetics* / Q000517:prevention & control; D003920:Diabetes Mellitus / Q000235:genetics; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000235:genetics; D012306:Risk; D012907:Smoking / Q000150:complications; D014280:Triglycerides / Q000097:blood
D014280:Triglycerides; D002784:Cholesterol