Genetics and coronary artery disease: present and future.

Abstract

D uring the last decade we have witnessed remarkable development in the field of genetics. This was due to great technological progress in the laboratory, through mapping and analysing the human genetic substrate and its association with diseases, and a better understanding of molecular and genetic mechanisms, allowing a more detailed comprehension of the role of genetics and environment in determining the risk of disease. It was inevitable that geneticists would focus their attention on ischemic cardiovascular disease, since this and its underlying pathological processes (atherosclerosis and thrombosis) are the leading cause of morbidity and mortality in the world. Coronary heart disease (CHD) is the leading cause of mortality worldwide, in both highand low-income countries, according to the latest data of the World Health Organization. In a report updated in 2011, the death rate from ischemic heart disease worldwide amounted to 12.8%.1 In the USA, according to a recent report of the American Heart Association, there was a reduction of cardiovascular mortality by 32.7% in the decade 1999-2009. But despite this decrease, deaths from cardiovascular disease in 2009 amounted to 32.3% of all deaths. For coronary disease per se, a coronary event occurs every 34 seconds and a death every minute, while one out of every six deaths is attributed to CHD.2 Evidence of genetic predisposition to CHD