Do we need diagnostic strategies enhanced with genetic information for ischemic heart disease?

Highlights from the article: However, these recommendations lead to the selection of a limited population with a certain stage of symptoms and thus relatively advanced IHD, whereas an earlier stage of IHD development might also constitute a useful therapeutic target group from a longer-term perspective. Other conventional risk factors are extracted from demographic data (age, gender) and, finally, also involve family history, one of the strongest risk factors for IHD although the latter does not reflect the totality of the overall high heritability of cardiovascular diseases.[8] This heritability has indeed been estimated to correspond to range from 40% to 60% with a large proportion being independent of conventional risk factors.[9] In the present issue of the Journal of Nuclear Cardiology, the association between gene polymorphisms and myocardial perfusion, investigated through SPECT-derived parameters, has been addressed by Angelidis et al.[10] The assessed polymorphisms were those of genes coding for the renin-angiotensin-aldosterone system (RAAS). In this subgroup, abnormal SPECT was documented in 73.5% of the subjects who were homozygous for the deletion allele and in 63.1% of those who had the heterozygote form, compared with only 42% of those who did not have the deletion allele ( I P i = 0.005).