Genetic epidemiology of coronary artery disease

Abstract

Evidence for unmeasured genes for established coronary artery disease risk factors, including smoking, obesity, blood pressure levels, measures of lipid metabolism, and diabetes, has been reported by many investigators studying diverse populations. In addition, many studies have also found evidence for unmeasured genes for several of the proposed risk factors (see table 1) including apolipoprotein AI, lipoprotein(a), insulin levels, and fibrinogen. Evidence for specific candidate genes or anonymous DNA markers being associated with risk factors is accumulating rapidly. Within a few years, most of the risk factors, both established and proposed, will be found to be associated with specific measured genes. Except for apo E, no specific candidate gene or anonymous marker has been consistently associated with coronary artery disease endpoints. Few studies relating candidate genes to coronary artery disease endpoints have been replicated, and few have considered risk factors simultaneously with candidate genes. The next few years should provide us with many new genes for coronary artery disease endpoints as well as an opportunity to begin to understand how these genotypes modify disease susceptibility in the presence or absence of specific risk factors.