title: Parental consanguinity and family history of coronary artery disease strongly predict early stenosis.
abstract: BACKGROUND
  Coronary artery disease (CAD) is a multifactorial disease with acquired and inherited components.
  
  
  OBJECTIVE
  We investigated the roles of family history and consanguinity on CAD risk and age at diagnosis in 4284 patients. The compounded impact of diabetes, hyperlipidemia, hypertension, smoking, and BMI, which are known CAD risk factors, on CAD risk and age at diagnosis was also explored.
  
  
  METHODS
  CAD was determined by cardiac catheterization. Logistic regression and stratification were performed to determine the impact of family history and consanguinity on risk and onset of CAD, controlling for diabetes, hyperlipidemia, hypertension, smoking, and BMI.
  
  
  RESULTS
  Family history of CAD and gender significantly increased the risk for young age at diagnosis of CAD (p<0.001). Consanguinity did not promote risk of CAD (p=0.38), but did affect age of disease diagnosis (p<0.001). The mean age at disease diagnosis was lowest, 54.8 years, when both family history of CAD and consanguinity were considered as unique risk factors for CAD, compared to 62.8 years for the no-risk-factor patient category (p<0.001).
  
  
  CONCLUSIONS
  Family history of CAD and smoking are strongly associated with young age at diagnosis. Furthermore, parental consanguinity in the presence of family history lowers the age of disease diagnosis significantly for CAD, emphasizing the role of strong genetic and cultural CAD modifiers. These findings highlight the increased role of genetic determinants of CAD in some population subgroups, and suggest that populations and family structure influence genetic heterogeneity between patients with CAD.
authors.affiliation: Lebanese American University, School of Medicine, Beirut 1102 2801, Lebanon.
authors.forename: Sonia
authors.initials: S
authors.lastname: Youhanna
authors.forename: Daniel E
authors.initials: DE
authors.lastname: Platt
authors.forename: Abdallah
authors.initials: A
authors.lastname: Rebeiz
authors.forename: Michael
authors.initials: M
authors.lastname: Lauridsen
authors.forename: Mary E
authors.initials: ME
authors.lastname: Deeb
authors.forename: Antoine
authors.initials: A
authors.lastname: Nasrallah
authors.forename: Samir
authors.initials: S
authors.lastname: Alam
authors.forename: Houry
authors.initials: H
authors.lastname: Puzantian
authors.forename: Samer
authors.initials: S
authors.lastname: Kabbani
authors.forename: Melanie
authors.initials: M
authors.lastname: Ghoul
authors.forename: Tony G
authors.initials: TG
authors.lastname: Zreik
authors.forename: Hamid
authors.initials: H
authors.lastname: el Bayeh
authors.forename: Antoine
authors.initials: A
authors.lastname: Abchee
authors.forename: Pierre
authors.initials: P
authors.lastname: Zalloua
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D003241:Consanguinity; D003251:Constriction, Pathologic / Q000175:diagnosis / Q000209:etiology / Q000235:genetics*; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000209:etiology / Q000235:genetics*; D005192:Family Health; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D012307:Risk Factors