title: Impact of family history of coronary artery disease in young individuals (from the CONFIRM registry).
abstract: Although family history (FH) of coronary artery disease (CAD) is considered a risk factor for future cardiovascular events, the prevalence, extent, severity, and prognosis of young patients with FH of CAD have been inadequately studied. From 27,125 consecutive patients who underwent coronary computed tomographic angiography, 6,308 young patients (men aged <55 years and women aged <65 years) without known CAD were identified. Obstructive CAD was defined as >50% stenosis in a coronary artery >2 mm diameter. Risk-adjusted logistic regression, Kaplan-Meier, and Cox proportional-hazards models were used to compare patients with and without FH of CAD. Compared with subjects without FH of CAD, those with FH of CAD (FH+) had higher prevalences of any CAD (40% vs 30%, p <0.001) and obstructive CAD (11% vs 7%, p <0.001), with multivariate odds of FH+ increasing the likelihood of obstructive CAD by 71% (p <0.001). After a mean follow-up period of 2 ± 1 years (42 myocardial infarctions and 39 all-cause deaths), FH+ patients experienced higher annual rates of myocardial infarction (0.5% vs 0.2%, log-rank p = 0.001), with a positive FH the strongest predictor of myocardial infarction (hazard ratio 2.6, 95% confidence interval 1.4 to 4.8, p = 0.002). In conclusion, young FH+ patients have higher presence, extent, and severity of CAD, which are associated with increased risk for myocardial infarction. Compared with other clinical CAD risk factors, positive FH in young patients is the strongest clinical predictor of future unheralded myocardial infarction.
authors: Department of Imaging, Cedars-Sinai Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
authors: Yuka
authors: Y
authors: Otaki
authors: Heidi
authors: H
authors: Gransar
authors: Daniel S
authors: DS
authors: Berman
authors: Victor Y
authors: VY
authors: Cheng
authors: Damini
authors: D
authors: Dey
authors: Fay Y
authors: FY
authors: Lin
authors: Stephan
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authors: Achenbach
authors: Mouaz
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authors: Al-Mallah
authors: Matthew J
authors: MJ
authors: Budoff
authors: Filippo
authors: F
authors: Cademartiri
authors: Tracy Q
authors: TQ
authors: Callister
authors: Hyuk-Jae
authors: HJ
authors: Chang
authors: Kavitha
authors: K
authors: Chinnaiyan
authors: Benjamin J W
authors: BJ
authors: Chow
authors: Augustin
authors: A
authors: Delago
authors: Martin
authors: M
authors: Hadamitzky
authors: Joerg
authors: J
authors: Hausleiter
authors: Philipp
authors: P
authors: Kaufmann
authors: Erica
authors: E
authors: Maffei
authors: Gilbert
authors: G
authors: Raff
authors: Leslee J
authors: LJ
authors: Shaw
authors: Todd C
authors: TC
authors: Villines
authors: Allison
authors: A
authors: Dunning
authors: James K
authors: JK
authors: Min
mesh_terms: D000328:Adult; D016009:Chi-Square Distribution; D003287:Contrast Media; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000235:genetics*; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D015995:Prevalence; D011379:Prognosis; D016016:Proportional Hazards Models; D012042:Registries; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed; D014481:United States / Q000453:epidemiology
chemical_list: D003287:Contrast Media