Coronary Artery Disease Case Study

Coronary artery disease (CAD) is the leading cause of death worldwide ( Reddy 1993; Lloyd-Jones et al. 2009). According to WHO, 23.6 million deaths each year by 2030 are caused by cardiovascular disease. In Malaysia, diseases of the circulatory system are the leading cause of death in Ministry of Health (MoH) Hospitals in 2012. 40, 000 new cases per year for 28 million people in this country while for number of CAD cases for young people which is below 45 years old is increased every year. 95 % of the cases involved men. In general, younger subjects with coronary artery disease have multiple risk factors that tradition to this disease. They also have a different risk profile from the profile of older patients (Chouhan et al. 1993; Hoit et

In addition to lifestyle and environmental factors, multiple combinations of gene-gene and gene-environment interactions play a key role in the development of CAD (Padmanabhan et al. 2010; Franchini et al. 2008). In addition to such risk factors, multiple combinations of gene-gene and gene-environment interactions play a key role in the development of CAD (Padmanabhan et al. 2010; Franchini et al. 2008). Surprisingly, 15-20% of patients with myocardial infarction (MI) have none of the traditional risk factors for CAD (Thanassoulis G. & O’Donnell C.J 2009). Such patients often have a family history of MI, which has long been associated with CAD and confers a nearly twofold increase in risk (Lloyd-Jones et al, 2004). Following this discovery, it has stimulated an intense search for the genetic determinants of

The patients with eNOS TT genotype had 15 fold risk of coronary artery disease compared with the control group [OR=15.356(CI 95% 3.262— 77.289, p=0.001)] (Cam et al. 2005). So does in Greece population, a significantly higher frequency of homozygosity for the 786C (32%) and the 894T (21%) alleles of the eNOS gene in patients who develop early MI (Zigra et al. 2013). In Korean study, the eNOS polymorphisms were not an independent predisposition factor to coronary artery disease. However, there is significant association in 786TNC polymorphism in CAD patients when adjusted with various cardiovascular risk factors (Kim et al.