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Twinning: Coronary Artery Disease in Monozygotic Twins

Megan C Smith1, John R Baker2, Evan Gleaves3

  • 1Cardiology, University of Kentucky, Bowling Green, USA.

Cureus
|August 9, 2021
PubMed

Insights

Identical twins experienced premature myocardial infarction (heart attack) due to severe coronary artery disease (CAD). Genetic and environmental factors in twin cardiovascular health warrant further investigation for early screening.

Area of Science:

  • Cardiology
  • Genetics
  • Preventive Medicine

Background:

  • Coronary artery disease (CAD) is a leading cause of mortality worldwide.
  • Genetic predisposition plays a significant role in cardiovascular health.
  • Familial clustering of CAD suggests shared genetic and environmental influences.

Observation:

  • A patient presented with symptoms mirroring his identical twin brother, who died of myocardial infarction at age 40.
  • The patient's ischemic evaluation revealed comparable coronary anatomy and severe CAD.
  • This case highlights a potential genetic link in premature CAD within monozygotic twins.

Findings:

  • Shared genetic factors may influence coronary anatomy and atherosclerotic lesion distribution in identical twins.
  • Environmental factors, interacting with genetic susceptibility, likely contribute to CAD development.
  • Early screening for CAD in individuals with a positive family history, especially in twins, is crucial.

Implications:

  • This case underscores the importance of considering genetic factors in the assessment of cardiovascular risk.
  • Further research into genetic and environmental interactions in twin cardiovascular health is needed.
  • Tailored screening protocols for high-risk twin pairs could improve early detection and prevention of CAD.

Keywords:
coronary artery angiographycoronary artery interventiongenetics of coronary artery diseasemonozygous twinsmultivessel coronary artery disease (mvcad)

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