Introduction: Despite all available theoretical assumptions, there is no study defining the prevalence of lipid and lipoprotein abnormalities among siblings of young acute myocardial infarction (MI) patients. This is the first such study. Methods: This was a case-control study. A total 110 siblings of young acute MI patients (Group A) and 50 healthy young controls (Group B) were studied for a duration of 2 years. Clinical profiles included age, sex, smoking, hypertension, diabetes mellitus, abdominal obesity and dyslipidemia for both cases and controls.The primary objective was to study the prevalence of dyslipidemia and lipoprotein abnormalities. The secondary objective was to study the prevalence of conventional risk factors among siblings of young (<45 years) acute MI patients. Results: On analyzing lipid profiles, it was found that total cholesterol, triglycerides, low-density lipoprotein, ApoB100, ApoB100: ApoA-1 ratio, and lipoprotein (a) were significantly raised in Group A in comparison to Group B. On studying conventional risk factors, it was observed that history of smoking, hypertension, diabetes mellitus, and increased waist circumference were more prevalent in Group A in comparison to Group B. Conclusion: Conventional atherosclerotic risk factors, lipid and lipoprotein abnormalities were significantly more prevalent in siblings of young acute MI patients in comparison to healthy controls and may be an answer to the possible cause of familial clustering in young MI emphasizing the importance of familial screening. Therefore, intensive efforts should be made to identify and alter modifiable risk factors in these cases. Keywords: Acute coronary syndrome, Apolipoproteins, Dyslipidemia, Lipoprotein (a), Myocardial infarction.Nowadays coronary heart disease (CHD) is the main cause of death all over the world due to sedentary lifestyle . The age group above 45 years is the most widely affected by acute myocardial infarction (MI). However, nowadays due to stressful life attributable to psychological, social and financial constraints, persons below 45 years presenting with acute MI are no exception. The main causes for increasing incidence of these events in the younger age group are physical inactivity, smoking, unhealthy diet, obesity, stressful life with overlapping appointments, and family history. The cut-off age of 45 has been used in most studies to define young patients with MI and the same age criteria was used in this study

Family and twin studies are consistent in showing the strong influence of genetic factors on premature coronary artery disease (CAD). Several prospective studies indicate that a family history of premature CHD is an independent risk factor even when other risk factors are taken into account [8-10]. The relative risk for CHD in first-degree relatives has been reported to be as high as 2–12 times that of the general population. Familial clustering may be due to genetic resemblance between members of the family, common family environment, or a probable contribution of both factors. Members of a family will tend to share similar environmental factors such as occupational classification, diet, smoking, exercise habits, and psychosocial stress, which have been shown to be related to the incidence of ischemic heart disease. This will perhaps be true of siblings rather more than of parent and child.

A large US study of persons developing CHD before the age of 60 years showed that low-density lipoprotein (LDL) cholesterol concentration of>130 mg/dL was more than twice as common in asymptomatic siblings under the age of 60 years as in the population at large (38% vs. 16%). Analogous but much less pronounced differences were observed in the European Atherosclerosis Research Study (EARS)  which investigated young adults with a paternal history of MI before the age of 55 years. In this study the best lipoprotein discriminants were plasma ApoB100 and triglyceride concentrations, which were higher in those with a positive family history of premature CHD compared to age and sex matched controls.
 

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