title: Impact of family history on the presentation and clinical outcomes of coronary heart disease: data from the Korea Acute Myocardial Infarction Registry.
abstract: OBJECTIVE
  Family history (FHx) of coronary heart disease (CHD) is a well-known risk factor for CHD. However, the prognostic implication of FHx has not been established clearly in patients with acute myocardial infarction (AMI).
  
  
  METHODS
  In total, 11,612 patients (8,132 males [70%], age 63 ± 13 years) with first-onset AMI between November 2005 and June 2008 in a nationwide, prospective, multicenter, online registry (the Korea AMI Registry) were analyzed. Clinical characteristics and outcomes (cardiac death and major adverse cardiac events [MACEs]) were assessed according to the presence of FHx.
  
  
  RESULTS
  The patients with FHx were younger and included more males. Male patients with FHx included more current smokers and individuals with poor lipid profiles. In all patients, after adjustment using the Cox proportional hazard model, FHx was related to the risk of MACEs (hazard ratio [HR], 1.41; p = 0.009) and cardiac death (HR, 1.56; p = 0.080). The poor prognostic implication of FHx was further augmented in females and a low risk subset of patients. A significant interaction was only found between male and female patients for composite MACEs (p for interaction = 0.057), and between patients with more risk factors (≥ 2 risk factors) and fewer risk factors for cardiac deaths (p for interaction = 0.008).
  
  
  CONCLUSIONS
  FHx may be an independent prognostic predictor, especially in female patients and patients with low-risk profile.
authors.affiliation: Severance Cardiovascular Center, Yonsei University Health System, Seoul, Korea.
authors.forename: Choongki
authors.initials: C
authors.lastname: Kim
authors.forename: Hyuk-Jae
authors.initials: HJ
authors.lastname: Chang
authors.forename: Iksung
authors.initials: I
authors.lastname: Cho
authors.forename: Ji Min
authors.initials: JM
authors.lastname: Sung
authors.forename: Donghoon
authors.initials: D
authors.lastname: Choi
authors.forename: Myung Ho
authors.initials: MH
authors.lastname: Jeong
authors.forename: Yang Soo
authors.initials: YS
authors.lastname: Jang
mesh_terms: D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000235:genetics* / Q000401:mortality / Q000628:therapy; D005260:Female; D020022:Genetic Predisposition to Disease; D040941:Heredity; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000235:genetics* / Q000401:mortality / Q000628:therapy; D010375:Pedigree; D062645:Percutaneous Coronary Intervention; D011379:Prognosis; D016016:Proportional Hazards Models; D012042:Registries; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors
keywords: Coronary disease; Epidemiology; Myocardial infarction; Risk factors