More than 60 years ago, Gertler et al1 first described the risk factors present in 100 individuals who experienced a myocardial infarction at an age younger than 40 years. They suggested that “efforts should be made to determine which individuals have the greatest tendencies to myocardial infarction.”1(p621) Despite remarkable advances in the treatment and prevention of cardiovascular disease during the last 6 decades, the challenge to identify young individuals who are at risk for developing coronary heart disease (CHD) remains.