title: Determinants of early-onset cardiovascular disease: a case-control study of young myocardial infarction patients.
abstract: BACKGROUND
  The present case-control investigation was undertaken with the aim of thoroughly assessing the risk profile of young coronary patients and to correlate it with their endothelium-dependent vasodilation and with the presence of atherosclerotic lesions.
  
  
  METHODS
  Forty-eight subjects (age < 41 years) diagnosed with myocardial infarction were screened. They were matched 1:1, for age and sex, with controls. We evaluated the serum total, HDL-, and LDL-cholesterol, triacylglycerols, fibrinogen, homocysteine, folic acid, vitamin B12, vitamin E, antioxidant capacity, and uric acid levels, and we also analyzed the patients for the presence of Helicobacter pylori and of methylenetetrahydrofolate reductase and cystathionine beta-synthase genetic mutations. Post-ischemic vasodilation of the brachial artery was evaluated and the intima-media thickness of the carotid arteries was measured at echo-Doppler.
  
  
  RESULTS
  A statistical modeling selection between block variables revealed that smoking, the apoepsilon genotype, dyslipidemia, fibrinogen, vitamin E concentrations, and intima-media thickness were important predictors of cardiovascular disease, with an accuracy of 91.7%.
  
  
  CONCLUSIONS
  On the basis of these results, we believe that acute coronary events in young subjects should be followed by a screening of their siblings, as they might be at higher risk for cardiovascular disease.
authors.affiliation: University of Brescia, Brescia, Italy.
authors.forename: Deodato
authors.initials: D
authors.lastname: Assanelli
authors.forename: Andrea
authors.initials: A
authors.lastname: Bonanome
authors.forename: Mario
authors.initials: M
authors.lastname: Grassi
authors.forename: Silvana
authors.initials: S
authors.lastname: Archetti
authors.forename: Riccardo
authors.initials: R
authors.lastname: Negrini
authors.forename: Alessandro
authors.initials: A
authors.lastname: Pezzini
authors.forename: Salvatore
authors.initials: S
authors.lastname: Curello
authors.forename: Francesco
authors.initials: F
authors.lastname: Visioli
mesh_terms: D000328:Adult; D001161:Arteriosclerosis / Q000235:genetics; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000235:genetics; D008055:Lipids / Q000097:blood; D008297:Male; D015233:Models, Statistical; D009203:Myocardial Infarction / Q000097:blood / Q000453:epidemiology / Q000235:genetics*; D018570:Risk Assessment; D035781:Siblings
chemical_list: D008055:Lipids