title: Non-identical yet similar: presentation of coronary artery disease in dizygotic twins.
abstract: There is a considerable debate regarding the role of genetic and the environmental factors in the pathogenesis of coronary artery disease (CAD). Since twin pairs are exposed to similar prenatal and postnatal environmental factors, a particular role of genetic vs. environmental factors can be evaluated by investigating the twins. We report a case of a dizygotic twin-pair who presented with simultaneous development of coronary insufficiency, and underwent coronary angiography and stent implantation on the same day. There were striking similarities and differences in certain characteristics between the presenting twins. We believe that the occurrence of CAD might be predetermined genetically, while the location of CAD lesion and its severity might be subjected to the modification of environmental factors among dizygotic twins. Considering the high risk of CAD-related fatal events in monozygotic and dizygotic twins, we recommend aggressive medical surveillance for a twin individual, whose co-twin has reported a cardiac event.
authors.affiliation: 1 Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences & Research, Bangalore-560069, Karnataka, India ; 2 Department of Clinical Trials, Sahajanand Medical Technologies Pvt. Ltd., Surat-395004, Gujarat, India.
authors.forename: Shivanand S
authors.initials: SS
authors.lastname: Patil
authors.affiliation: 1 Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences & Research, Bangalore-560069, Karnataka, India ; 2 Department of Clinical Trials, Sahajanand Medical Technologies Pvt. Ltd., Surat-395004, Gujarat, India.
authors.forename: Rangraj
authors.initials: R
authors.lastname: Ramalingam
authors.affiliation: 1 Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences & Research, Bangalore-560069, Karnataka, India ; 2 Department of Clinical Trials, Sahajanand Medical Technologies Pvt. Ltd., Surat-395004, Gujarat, India.
authors.forename: Kasamshetty
authors.initials: K
authors.lastname: Subramanyam
authors.affiliation: 1 Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences & Research, Bangalore-560069, Karnataka, India ; 2 Department of Clinical Trials, Sahajanand Medical Technologies Pvt. Ltd., Surat-395004, Gujarat, India.
authors.forename: Deepak
authors.initials: D
authors.lastname: Pujar
authors.affiliation: 1 Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences & Research, Bangalore-560069, Karnataka, India ; 2 Department of Clinical Trials, Sahajanand Medical Technologies Pvt. Ltd., Surat-395004, Gujarat, India.
authors.forename: Cholenahally Nanjappa
authors.initials: CN
authors.lastname: Manjunath
authors.affiliation: 1 Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences & Research, Bangalore-560069, Karnataka, India ; 2 Department of Clinical Trials, Sahajanand Medical Technologies Pvt. Ltd., Surat-395004, Gujarat, India.
authors.forename: Nirlep
authors.initials: N
authors.lastname: Gajiwala
authors.affiliation: 1 Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences & Research, Bangalore-560069, Karnataka, India ; 2 Department of Clinical Trials, Sahajanand Medical Technologies Pvt. Ltd., Surat-395004, Gujarat, India.
authors.forename: Ashok
authors.initials: A
authors.lastname: Thakkar
keywords: Coronary angiography; coronary artery disease (CAD); dizygotic; risk factor; twins