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[Coronary disease in homozygous twins. Respective roles of heredity and environment]
Insights
Identical twins experienced early-onset cardiac ischemia from coronary atheroma, despite similar risk factors. This case study explores the interplay of genetics and environment in the development of atherosclerosis.
Area of Science:
- Cardiology
- Genetics
- Epidemiology
Background:
- Investigates early-onset cardiac ischemia in identical twins.
- Examines coronary atheroma development and progression.
- Compares genetic predisposition versus environmental factors.
Observation:
- Two 44-year-old identical twins presented with cardiac ischemia due to coronary atheroma at ages 39 and 43.
- Both twins shared comparable coronary risk factors including hypertension, smoking, hypercholesterolemia, obesity, and oral contraceptive use.
- Electrocardiographic changes and coronary angiography revealed similar patterns in both individuals.
Findings:
- Despite comparable risk factors, the onset and presentation of coronary atheroma differed slightly between the twins.
- The study highlights a potential genetic predisposition to early-onset coronary atheroma, even with shared environmental influences.
- Analysis suggests a complex interaction between hereditary factors and lifestyle in the pathogenesis of coronary artery disease.
Implications:
- Understanding the genetic and environmental contributions to coronary atheroma is crucial for personalized prevention strategies.
- This case underscores the importance of considering genetic predisposition in individuals with premature cardiovascular disease.
- Further research into the genetic underpinnings of atherosclerosis may lead to novel therapeutic targets.
Abstract:
Two 44 year old female homozygote twins presented with cardiac ischaemia due to coronary atheroma, at 39 years of age and 43 years of age, respectively. The coronary risk factors (hypertension, cigarette smoking, hypercholesterolaemia, obesity, oral contraception) were comparable in both cases. Although presenting at different times, the electrocardiographic changes were in the same territory and coronary angiography showed a similar anatomical and lesional distribution. The literature is reviewed with respect to these cases to try to determine the respective roles of heredity and the environment in the initiation and progression of coronary atheroma.