According to a research, the major risk factor for the occurrence of MI at a very young age is the familial-combined hyperlipidemia (FCHL) phenotype which is characterized by hypercholesterolemia and hypertriglyceridemia.

A multicenter, hospital-based, case-control study prospectively enrolled 102 consecutive MI survivors younger than 40 years of age. There was a frequency-match in patients for age, gender, and center to 200 control subjects free of coronary heart disease. All MI patients were invited to send first-degree relatives for lipid screening. A total of 37 families and 120 family members were screened.

Five control subjects (2.5%) and 38 acute MI patients (38%) had FCHL. Sixteen acute MI patients (76%) who had the FCHL phenotype and had family members available (n = 21) were confirmed for diagnosis of FCHL. The FCHL phenotype was linked to a 24-fold increased acute MI risk (p < 0.001). VLDL-cholesterol and non-HDL-cholesterol lipid parameters were most strongly associated with acute MI in this population.

FCHL can easily be detected using a recently published nomogram, told Dr. Wiesbauer. Many physicians and even cardiologists are not familiar with FCHL. Our study should raise the awareness of the disease.

Further studies are needed in order to test if more aggressive treatment strategies in patients who test positive for FCHL will lead to fewer deaths and myocardial infarctions, Dr. Wiesbauer said.