Neither presence of IHD, no age > 80 years per se are predictive of PMI and/or a fatal outcome if these clinical characteristics are not combined with at least one of the following metabolic abnormalities: vitamin D insufficiency/deficiency, hypoalbuminaemia, hyperparathyroidism, GGT/ALT > 2.5, Urea > 7.5 mmol/l, or Urea/Albumin ≥ 2.0. The gene discussed is GPT; the disease is myocardial ischemia.