{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T11:50:03Z","timestamp":1753876203860,"version":"3.41.2"},"reference-count":17,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2023,2,28]],"date-time":"2023-02-28T00:00:00Z","timestamp":1677542400000},"content-version":"vor","delay-in-days":29,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,2,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The development of coronary artery disease (CAD) is strongly influenced by genetic and environmental factors. Monozygotic twins represent a unique population that provides insights into the interaction of genetic, environmental, and social factors and their effects on the development of CAD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case summary<\/jats:title><jats:p>Two 54-year-old identical twins presented to an outside hospital with acute chest pain. Twin B developed chest pain after witnessing Twin A in distress from an acute chest pain episode. Electrocardiogram performed on each of them was diagnostic of ST-elevation myocardial infarction. Upon arrival at the angioplasty centre, Twin A was taken for emergency coronary angiography yet his pain subsided on the way to the catheterization lab hence, Twin B was taken for angiography instead. Twin B angiography demonstrated acute occlusion of the proximal left anterior descending coronary artery and was treated with percutaneous coronary intervention. Twin A coronary angiogram demonstrated 60% ostial first diagonal branch stenosis with a normal distal flow. He was diagnosed with possible coronary vasospasm.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This is the first report of a simultaneous presentation of monozygotic twins with ST-elevation acute coronary syndrome. While genetic and environmental contributions to the development of CAD have been described, this case highlights the strong social bond that exists between monozygotic twins. Once CAD is diagnosed in one twin, aggressive risk factor modification and screening should be implemented in the other.<\/jats:p><\/jats:sec>","DOI":"10.1093\/ehjcr\/ytad050","type":"journal-article","created":{"date-parts":[[2023,1,30]],"date-time":"2023-01-30T21:21:18Z","timestamp":1675113678000},"source":"Crossref","is-referenced-by-count":1,"title":["Simultaneous ST-elevation myocardial infarction in monozygotic twins: a case report of entangled twins"],"prefix":"10.1093","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4878-4663","authenticated-orcid":false,"given":"Kameel","family":"Kassab","sequence":"first","affiliation":[{"name":"Division of Cardiology, Ascension Borgess Heart Institute , GOC 331, 1521 Gull Road, Kalamazoo, MI 49048 , USA"},{"name":"Department of Cardiology, Michigan State University , East Lansing, MI 48824 , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vishal","family":"Gupta","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Ascension Borgess Heart Institute , GOC 331, 1521 Gull Road, Kalamazoo, MI 49048 , USA"},{"name":"Department of Cardiology, Michigan State University , East Lansing, MI 48824 , USA"},{"name":"Department of Cardiology, Western Michigan University Homer Stryker M.D. School of Medicine , Kalamazoo, MI 49008 , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2023,1,30]]},"reference":[{"key":"2023030116315398500_","first-page":"e6","article-title":"Heart disease and stroke statistics\u20132013 update: a report from the American heart association","volume":"127","author":"Go","year":"2013","journal-title":"Circulation"},{"key":"2023030116315398500_","doi-asserted-by":"crossref","first-page":"564","DOI":"10.1161\/CIRCRESAHA.115.306566","article-title":"Genetics of coronary artery disease","volume":"118","author":"McPherson","year":"2016","journal-title":"Circ Res"},{"key":"2023030116315398500_","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1510\/icvts.2007.153445","article-title":"The comparison of angiographic lesions and clinical outcomes in identical twins","volume":"6","author":"Gullu","year":"2007","journal-title":"Interact Cardiovasc Thorac Surg"},{"key":"2023030116315398500_","first-page":"145","article-title":"Non-identical yet similar: presentation of coronary artery disease in dizygotic twins","volume":"5","author":"Patil","year":"2015","journal-title":"Cardiovasc Diagn Ther"},{"key":"2023030116315398500_","doi-asserted-by":"crossref","DOI":"10.1136\/bcr-2020-238272","article-title":"Myocardial infarction in monozygotic twins","volume":"13","author":"Clement","year":"2020","journal-title":"BMJ Case Rep"},{"key":"2023030116315398500_","doi-asserted-by":"crossref","DOI":"10.1161\/CIRCIMAGING.121.013348","article-title":"Heritability of coronary artery disease: insights from a classical twin study","volume":"15","author":"Drobni","year":"2022","journal-title":"Circ Cardiovasc Imaging"},{"key":"2023030116315398500_","doi-asserted-by":"crossref","first-page":"855","DOI":"10.1161\/01.CIR.0000155611.41961.BB","article-title":"Distinct heritable patterns of angiographic coronary artery disease in families with myocardial infarction","volume":"111","author":"Fischer","year":"2005","journal-title":"Circulation"},{"key":"2023030116315398500_","first-page":"6","article-title":"Enigma of twins: identical presentation and angiographic lesion in monozygotic twins","volume":"34","author":"Singh","year":"2022","journal-title":"J Saudi Heart Assoc"},{"key":"2023030116315398500_","article-title":"Twinning: coronary artery disease in monozygotic twins","volume":"13","author":"Smith","year":"2021","journal-title":"Cureus"},{"key":"2023030116315398500_","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1136\/heart.83.1.47","article-title":"Comparative coronary anatomy in six twin pairs with coronary artery disease","volume":"83","author":"Frings","year":"2000","journal-title":"Heart"},{"key":"2023030116315398500_","doi-asserted-by":"crossref","first-page":"594","DOI":"10.1016\/S0003-4975(99)00629-3","article-title":"Coronary artery disease in identical twins","volume":"68","author":"Samuels","year":"1999","journal-title":"Ann Thorac Surg"},{"key":"2023030116315398500_","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1093\/eurheartj\/16.1.134","article-title":"Coronary artery disease in identical twins","volume":"16","author":"Schilling","year":"1995","journal-title":"Eur Heart J"},{"key":"2023030116315398500_","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1016\/0002-9149(87)90819-8","article-title":"Clinical and angiographic similarities in twins with coronary artery disease","volume":"59","author":"Herrington","year":"1987","journal-title":"Am J Cardiol"},{"key":"2023030116315398500_","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1136\/hrt.45.2.193","article-title":"Coronary artery disease in twins","volume":"45","author":"Holmes","year":"1981","journal-title":"Br Heart J"},{"key":"2023030116315398500_","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1002\/ccd.1810010112","article-title":"Premature coronary artery disease in identical male twins studied by selective coronary arteriography","volume":"1","author":"Kreulen","year":"1975","journal-title":"Cathet Cardiovasc Diagn"},{"key":"2023030116315398500_","doi-asserted-by":"crossref","first-page":"1041","DOI":"10.1056\/NEJM199404143301503","article-title":"Genetic susceptibility to death from coronary heart disease in a study of twins","volume":"330","author":"Marenberg","year":"1994","journal-title":"N Engl J Med"},{"key":"2023030116315398500_","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0154774","article-title":"A twin protection effect? Explaining twin survival advantages with a two-process mortality model","volume":"11","author":"Sharrow","year":"2016","journal-title":"PLoS One"}],"container-title":["European Heart Journal - Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ehjcr\/advance-article-pdf\/doi\/10.1093\/ehjcr\/ytad050\/48950845\/ytad050.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/7\/2\/ytad050\/49168362\/ytad050.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/7\/2\/ytad050\/49168362\/ytad050.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,3,23]],"date-time":"2023-03-23T07:08:28Z","timestamp":1679555308000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjcr\/article\/doi\/10.1093\/ehjcr\/ytad050\/7009183"}},"subtitle":[],"editor":[{"given":"Andrew","family":"Peter Vanezis","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Lina","family":"Ya'qoub","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Denizhan","family":"Ozdemir","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Gal","family":"Tsaban","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Niklas","family":"Schenker","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2023,1,30]]},"references-count":17,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2023,2,3]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjcr\/ytad050","relation":{},"ISSN":["2514-2119"],"issn-type":[{"type":"electronic","value":"2514-2119"}],"subject":[],"published-other":{"date-parts":[[2023,2,1]]},"published":{"date-parts":[[2023,1,30]]},"article-number":"ytad050"}}