Contribution of major cardiovascular risk factors to familial premature coronary artery disease: the GENECARD project.
OBJECTIVE
This study was designed to assess the prevalence of major cardiovascular risk factors in familial premature coronary artery disease (P-CAD), affecting two or more siblings within one sibship.


BACKGROUND
Premature CAD has a genetic component. It remains to be established whether familial P-CAD is due to genes acting independently from major cardiovascular risk factors.


METHODS
We recruited 213 P-CAD survivors from 103 sibships diagnosed before age <or=50 (men) or <or=55 (women) years old. Hypertension, hypercholesterolemia, obesity, and smoking were documented at the time of the event in 163 patients (145 men and 18 women). Each patient was compared with two individuals of the same age and gender, diagnosed with sporadic (nonfamilial) P-CAD, and three individuals randomly sampled from the general population.


RESULTS
Compared with the general population, patients with sporadic P-CAD had a higher prevalence of hypertension (29% vs. 14%, p < 0.001), hypercholesterolemia (54% vs. 33%, p < 0.001), obesity (20% vs. 13%, p < 0.01), and smoking (76% vs. 39%, p < 0.001). These risk factors were equally or even more prevalent in patients with familial P-CAD (43% [p < 0.05 vs. sporadic P-CAD], 58% [p = 0.07], 21% and 72%, respectively). Overall, only 7 (4%) of 163 of patients with familial P-CAD and 22 (7%) of 326 of patients with sporadic P-CAD had none of these conditions, as compared with 167 (34%) of 489 patients in the general population.


CONCLUSIONS
Classic, remediable risk factors are highly prevalent in patients with familial P-CAD. Accordingly, a major contribution of genes acting in the absence of these risk factors is unlikely.
Department of Medicine, CHUV University Hospital, Lausanne, Switzerland.
Vincent
V
Jomini
Séverine
S
Oppliger-Pasquali
Vincent
V
Wietlisbach
Nicolas
N
Rodondi
Valérie
V
Jotterand
Fred
F
Paccaud
Roger
R
Darioli
Pascal
P
Nicod
Vincent
V
Mooser
D000328:Adult; D017668:Age of Onset; D002318:Cardiovascular Diseases; D003327:Coronary Disease / Q000235:genetics*; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000453:epidemiology; D006973:Hypertension / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000235:genetics; D009765:Obesity / Q000453:epidemiology; D010375:Pedigree; D015995:Prevalence; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology