title: Familial-combined hyperlipidaemia in very young myocardial infarction survivors (< or =40 years of age).
abstract: OBJECTIVE
  Myocardial infarction (MI) in very young individuals is a rare disease associated with an unfavourable prognosis. Familial-combined hyperlipidaemia (FCHL) increases the risk for MI in individuals below 60 years; however, its role in very young MI patients below 40 years is not as well established. We investigated the prevalence and impact of FCHL in these very young MI patients.
  
  
  RESULTS
  We prospectively enrolled 102 consecutive MI survivors (< or =40 years) from two high-volume cardiac catheterization centres. Patients were frequency-matched for age, gender, and centre to 200 hospital controls free from coronary heart disease. Myocardial infarction patients were invited to send family members for FCHL screening. Overall, 37 families were screened. Familial-combined hyperlipidaemia was diagnosed using a nomogram, which takes into account total cholesterol, triglycerides, and Apo B(100) levels. Thirty-eight acute myocardial infarction (AMI) patients (38%) and five controls (2.5%) displayed the FCHL phenotype, 21 of these MI patients sent family members for screening, and FCHL was confirmed in 16 families (76%). The FCHL phenotype was associated with a 24-fold increased adjusted risk for MI (95% CI 7.5-81, P < 0.001). Of all lipid parameters, VLDL-cholesterol, and non-HDL-cholesterol were most strongly associated with MI.
  
  
  CONCLUSIONS
  The present study suggests that the FCHL phenotype seems to be a major risk factor for the occurrence of MI at a very young age. It remains to be determined whether this excessively increased risk can be favourably modified by therapeutic interventions.
authors.affiliation: Department of Cardiology, Vienna General Hospital/Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria. franz.wiesbauer@meduniwien.ac.at
authors.forename: Franz
authors.initials: F
authors.lastname: Wiesbauer
authors.forename: Hermann
authors.initials: H
authors.lastname: Blessberger
authors.forename: Danyel
authors.initials: D
authors.lastname: Azar
authors.forename: Georg
authors.initials: G
authors.lastname: Goliasch
authors.forename: Oswald
authors.initials: O
authors.lastname: Wagner
authors.forename: Lukas
authors.initials: L
authors.lastname: Gerhold
authors.forename: Kurt
authors.initials: K
authors.lastname: Huber
authors.forename: Kurt
authors.initials: K
authors.lastname: Widhalm
authors.forename: Farshid
authors.initials: F
authors.lastname: Abdolvahab
authors.forename: Gottfried
authors.initials: G
authors.lastname: Sodeck
authors.forename: Gerald
authors.initials: G
authors.lastname: Maurer
authors.forename: Martin
authors.initials: M
authors.lastname: Schillinger
mesh_terms: D000328:Adult; D000367:Age Factors; D008078:Cholesterol, LDL / Q000378:metabolism; D005260:Female; D006801:Humans; D006950:Hyperlipidemia, Familial Combined / Q000150:complications / Q000235:genetics / Q000401:mortality*; D008297:Male; D009203:Myocardial Infarction / Q000401:mortality*; D015995:Prevalence; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D017741:Survivors
chemical_list: D008078:Cholesterol, LDL