Strategies for the assessment of genetic coronary artery disease risk

In atherosclerotic diseases, genetic factors have a substantial influence o n the age of onset and the frequency and severity of clinical symptoms, as well as response to therapy. In myocardial infarctions occurring at young a ge, genetics may be the leading causative factor. Despite such a prominent role of genetics in the pathophysiology of atherosclerosis clinical risk as sessment and therapeutic decision making are still based on classical risk factors. In this paper we analyse the reasons for the current lack of predi ctive power of genetics-based algorithms and we speculate why future develo pments might open the door to a role for genetics in the clinical managemen t of atherosclerosis. Curr Opin Lipidol 10:285-291. (C) 1999 Lippincott Wil liams & Wilkins.