Circulation, Vol 61, 503-508, Copyright © 1980 by American Heart Association
JJ Nora, RH Lortscher, RD Spangler, AH Nora and WJ Kimberling
A genetic-epidemiologic study was undertaken of a white Colorado population
of 207 patients who had a myocardial infarction before age 55 years.
Nineteen independent variables were compared between the 207 cases and 621
controls, matched 3:1. The highest risk ratios were associated with a
positive family history for ischemic heart disease (IHD). The heritability
of IHD was 63% when families with the monogenic forms of
hyperlipoproteinemia were included, and 56% when they were excluded. A risk
index was developed that incorporates family history into a data base of
risk factors, which can be readily assessed by the clinician obtaining a
screening history, physical and standard laboratory tests. A scale of 0-10
was devised and the predictive value of the index was tested against
another data set. The efficiency of the index was maximal at a screening
level of 5. This study suggests that it is logistically feasible to seek
patients at high risk for intensive management in a clinical setting
(high-risk strategy) using risk indices similar to the one developed for
this study, which emphasize the very important familial component to IHD.
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Genetic--epidemiologic study of early-onset ischemic heart disease
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