26/02/2026
The Inherited Basis of Coronary Artery Disease
👉 nej.md/4tmGZtI
Coronary artery disease develops from an interplay of behavioral, environmental, genetic, and stochastic factors. Smoking, hypertension, hyperlipidemia, and diabetes mellitus are well-recognized modifiable risk factors for coronary artery disease, which affects almost 1 in 2 men and 1 in 3 women during their lifetime. More than a century ago, Osler posited that inherited factors may cause coronary artery disease after he observed that angina pectoris often clusters in families. Approximately 30 years ago, twin studies indicated that the heritability of fatal coronary artery disease was as high as 50%. Since 2007, large-scale genotyping and gene-sequencing studies have identified hundreds of genetic variants associated with increased susceptibility to coronary artery disease (seen in figure). Protein products of some associated genes already constitute effective treatment targets, and other genes point to currently unexplored disease mechanisms.
An inquiry about a family history of coronary artery disease is routine in the clinical assessment of patients presenting with chest pain syndromes. Heribert Schunkert, MD, Pradeep Natarajan, MD (), and Nilesh J. Samani, MD, review recent discoveries regarding the molecular genetic origins of coronary atherosclerosis and discuss current and potential clinical uses of this information.
Read the Review Article “The Inherited Basis of Coronary Artery Disease” from Universitätsklinikum der Technischen Universität München; Deutsches Zentrum für Herz- und Kreislaufforschung, Partner Site Munich Heart Alliance (); and elsewhere: nej.md/4tmGZtI
