Coronary artery disease in twins.

Holmes, D. R.; Kennel, Anne; Smith, Hugh C.; Gordon, Hymie; Moore, Stephen

doi:10.1136/hrt.45.2.193

Cited by 18 publications

(12 citation statements)

References 10 publications

(3 reference statements)

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“…Our review of the available literature shows that 9 of 12 monozygotic twin pairs displayed concordance for proximal lesions, whereas only 3 of 12 were concordant for distal lesions. [5][6][7][8][9][10][11][12][13] This finding is congruent with our observation that stenoses are particularly heritable at proximal localizations. The reason for different heritability estimates of proximal and distal lesions remains speculative.…”

Section: Discussionsupporting

confidence: 82%

“…This finding is in agreement with other observational studies, which found considerable variability in the coronary blood supply in monozygotic twins. 5,[7][8][9][10] With regard to future research, our findings may open a new window of opportunity for screening strategies in relatives of CAD patients. Focusing on the most heritable manifestations of CAD might be an effective strategy to increase the power to detect susceptibility loci for such complex diseases.…”

Section: Fischer Et Al Heritable Patterns Of Angiographic Cad 859mentioning

confidence: 99%

“…Until now, only a few case reports on monozygotic or dizygotic twins have investigated the hereditary aspects of coronary morphology, but even these have produced inconsistent results. [5][6][7][8][9][10][11][12][13] Therefore, a large angiographic database for patients with familial MI was established to investigate the hypothesis that specific coronary morphologies have a genetic component. Detailed heritable disease patterns could enhance clinical risk characterization and offer new opportunities for clinical follow-up investigations in relatives of affected patients.…”

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confidence: 99%

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Distinct Heritable Patterns of Angiographic Coronary Artery Disease in Families With Myocardial Infarction

et al. 2005

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Background-Coronary artery disease (CAD) and myocardial infarction (MI) are significantly determined by genetic background. Whether distinct angiographic features of CAD are affected by inherited factors has never been investigated. Thus, we analyzed comprehensively the extent to which various aspects of CAD, including disease severity, distribution of lesions, presence of coronary calcification, morphology of stenoses, and anatomic characteristics, are under genetic control. Methods and Results-We retrospectively studied the coronary angiograms of 882 siblings with CAD from 401 families.These families were ascertained through index patients defined by MI before the age of 60 years and at least 1 sibling with MI or coronary revascularization procedures.

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Section: Discussionsupporting

confidence: 82%

Section: Fischer Et Al Heritable Patterns Of Angiographic Cad 859mentioning

confidence: 99%

mentioning

confidence: 99%

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Distinct Heritable Patterns of Angiographic Coronary Artery Disease in Families With Myocardial Infarction

et al. 2005

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“…Some of these found a concordant coronary blood supply,3-5 while some did not 46 7While our study can provide examples of both concordant and discordant blood supply in monozygotic twins, it is the first to attempt a more systematic approach to analysing the heredity of the coronary macroanatomy by comparing monozygotic and dizygotic twin pairs.…”

Section: Discussionmentioning

confidence: 69%

Comparative coronary anatomy in six twin pairs with coronary artery disease

Frings

2000

Heart

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Objective-To compare the coronary anatomy and the location of coronary lesions in monozygotic and dizygotic twin pairs aVected with coronary artery disease. Design-Coronary angiographic findings were compared with respect to the distribution of coronary blood supply and the location of coronary lesions. Main outcome measures-Distribution of coronary blood supply, diameters and length of proximal coronary arteries. Results-The lumen diameters of the left main coronary artery, the left anterior descending coronary artery, the circumflex artery, and the right coronary artery, as well as the lengths of the left main coronary artery, showed similar variability within monozygotic and dizygotic twin pairs. With respect to the dominance pattern of coronary blood supply, two of three monozygotic twin pairs diVered, while all dizygotic twin pairs were concordant. Concordant and discordant locations of stenoses were found with similar frequency in monozygotic and dizygotic twin pairs. Conclusions-The dominance pattern of coronary blood supply and the location of coronary lesions are not strictly hereditary. The high concordance of premature coronary artery disease found in monozygotic twin pairs may largely be related to factors that are independent of the macroanatomic distribution of the coronary blood supply. The chance of dying from coronary heart disease within 10 years is almost 50% for a 55 year old man if his monozygotic twin had a fatal myocardial infarction.1 This risk is about 20 times higher than for a representative individual in the overall population and 3.2-to sixfold higher than for the dizygotic twin of a patient with myocardial infarction.1 The question arises as to what mechanisms account for such a high concordance for myocardial infarction in the second monozygotic twin. We speculated that as well as having inherited risk factors aVected monozygotic twins may share the anatomy of their coronary arteries. In this respect it has been well documented that certain anatomical features may precipitate coronary atherosclerosis and occlusion.2 However, it is unknown whether the coronary anatomy in monozygotic twins is identical, as few case reports have evaluated this. [3][4][5][6][7] In order to study the heredity of coronary anatomy in more detail we compared the coronary arteries in three monozygotic and three dizygotic twin pairs by measuring key anatomical features and the location of coronary lesions. MethodsThree monozygotic and three dizygotic twin pairs were identified retrospectively by screening of 93 500 patient records in seven cardiac rehabilitation centres. All individuals had symptomatic premature coronary heart disease and were thus studied by cardiac catheterisation. All participants gave written informed consent for study of genetic risk factors for myocardial infarction.Anthropometric data, risk factors, and clinical events were taken from the patients' records. Obesity, hypertension, and dyslipidaemia were defined as previously suggested. 8 To document monozygosity and dizygosity...

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“…Some studies [1,2] describe similarities in coronary anatomy and age at clinical manifestation. Others [3,4] report differences in dominance, branching pattern, and concordance of coronary lesions.…”

Section: Discussionmentioning

confidence: 98%