Cultured skin fibroblasts from five patients with atherosclerosis who underwent coronary artery bypass graft surgery were compared with those from one ataxia telangiectasia (AT) homozygote, three AT heterozygotes, and five healthy subjects to determine their sensitivity to gamma radiation as determined by a colony survival assay. Fibroblasts from four of these patients were also compared with those from two AT homozygotes, two AT heterozygotes, and three healthy subjects to determine postirradiation [ 3 H]thymidine incorporation, indicating the levels of radioresistant DNA synthesis (RDS). On the basis of colony survival assay, after long-term irradiation (at low dose rate, ie, 0.007 Gy/min), fibroblasts from all five patients with atherosclerosis exhibited radiosensitivity that was intermediate between that of the healthy subjects and that of patients with the known radiosensitive syndrome AT. However, there was a considerable interstrain difference in the radiosensitivity of fibroblasts from patients with atherosclerosis, with their mean D lo values C ardiovascular diseases and cancer are the major causes of morbidity and mortality in many countries. Several studies have suggested that multifactorial processes are involved in the origin of these diseases.1 ' 2 The evidence of monoclonality, somatic mutations, and a possible involvement of mutagen/carcinogen exposure in both atherosclerosis and carcinogenesis strongly indicated that at some stage the two diseases may follow a similar pathway and share common risk factors. 36 This would, inter alia, imply that genetic factors that increase susceptibility to malignancies may also enhance the risk of developing atherosclerosis. Among various carcinogenic factors, ionizing radiation has almost conclusively been shown to be atherogenic.811 Therefore, it is expected that individuals with increased sensitivity to radiation would be prone to develop atherosclerosis. The inherited disorder ataxia telangiectasia (AT), an autosomal recessive syndrome that is highly susceptible to malignancies, is characterized by its cellular hypersensitivity to ionizing radiation (showing reduced cell survival) as well as Received May 31, 1994; revision accepted August 19, 1994. © 1994 American Heart Association, Inc.(radiation dose resulting in 10% cell survival) varying between 2.3 and 6.2 Gy, whereas the mean D lo values for the cells from the AT homozygote, AT heterozygotes, and healthy subjects were 2.0, 3.8, and 9.0 Gy, respectively. One of the patients with atherosclerosis showed cellular radiosensitivity quite similar to that of the AT homozygote, up to 2% to 10% of survival levels after short-(at a dose rate of 8 Gy/min) and long-term irradiation, respectively. The results of [ 3 H]thymidine incorporation showed an AT heterozygote-like RDS in fibroblasts from patients with atherosclerosis that appeared to be intermediate between that of AT homozygotes and that of healthy subjects, suggesting a partial deregulation of cell cycle in the patients with atherosclerosis. Ove...