Family history of coronary heart disease and the incidence and progression of coronary artery calcification: Multi-Ethnic Study of Atherosclerosis (MESA).
OBJECTIVE
We evaluated family history as a predictor of incident and progressive coronary artery calcium (CAC) using data from the Multi-Ethnic Study of Atherosclerosis (MESA).


BACKGROUND
MESA is a multi-center prospective study of 6814 asymptomatic individuals. The relationship between family history of coronary heart disease (CHD) and CAC incidence or progression has not been described previously.


METHODS
A total of 5099 participants had detailed information about family history of CHD (late versus premature and parental versus sibling history). The mean time between CAC scans was 3.1 ± 1.3 years. The association of late versus premature family history was assessed against CAC change using multivariate regression model adjusted for demographics and cardiac risk factors.


RESULTS
A family history of premature CHD was associated with an odds ratio (OR) of 1.55 (p < 0.01) for incident development of CAC after adjusting for risk factors and demographics. A premature family history was associated with 14.4 units (p < 0.01) greater volume scores compared to those with no family history in similarly adjusted models by median regression analysis. A combined parental and sibling family history was associated with the greatest incidence and progression in demographic-adjusted models. Caucasians demonstrated the most consistent predictive relationship between family history of premature CHD and incidence (p < 0.01) and progression (p < 0.05) of CAC, though no significant interaction with ethnicity was noted.


CONCLUSIONS
Family history of premature CHD is associated with enhanced development and progression of subclinical disease, independent of other risk factors, in a multiethnic, population-based study.
Department of Medicine, Johns Hopkins Hospital, Baltimore, MD, USA.
Arvind K
AK
Pandey
Johns Hopkins Ciccarone Preventive Cardiology Center, Baltimore, MD, USA.
Michael J
MJ
Blaha
Johns Hopkins Ciccarone Preventive Cardiology Center, Baltimore, MD, USA.
Kavita
K
Sharma
Johns Hopkins Ciccarone Preventive Cardiology Center, Baltimore, MD, USA.
Juan
J
Rivera
Division of Cardiology, Los Angeles Biomedical Research Institute at Harbor-UCLA, Torrance, CA, USA.
Matthew J
MJ
Budoff
Non-invasive Cardiovascular Imaging Program, Brigham and Women's Hospital, Boston, MA, USA.
Ron
R
Blankstein
Heart and Vascular Institute, Henry Ford Hospital, Detroit, MI, USA.
Mouaz
M
Al-Mallah
Division of Cardiology, University of California, Irvine, CA, USA.
Nathan D
ND
Wong
Division of Cardiology, Emory University, Atlanta, GA, USA.
Leslee
L
Shaw
Department of Radiology, Wake Forest University Health Sciences, Winston-Salem, NC, USA.
Jeffery
J
Carr
St. Elizabeth's Medical Center, Boston, MA, USA.
Daniel
D
O'Leary
Johns Hopkins Ciccarone Preventive Cardiology Center, Baltimore, MD, USA.
Joao A C
JA
Lima
Department of Epidemiology, Johns Hopkins University, Baltimore, MD, USA.
Moyses
M
Szklo
Johns Hopkins Ciccarone Preventive Cardiology Center, Baltimore, MD, USA.
Roger S
RS
Blumenthal
Johns Hopkins Ciccarone Preventive Cardiology Center, Baltimore, MD, USA; Center for Prevention and Wellness Research, Baptist Health Medical Group, Miami Beach, FL, USA; Department of Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA; Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami, FL, USA. Electronic address: KhurramN@baptisthealth.net.
Khurram
K
Nasir
D000368:Aged; D050197:Atherosclerosis / Q000150:complications / Q000453:epidemiology; D002114:Calcinosis / Q000150:complications* / Q000453:epidemiology*; D003327:Coronary Disease / Q000150:complications* / Q000453:epidemiology*; D018450:Disease Progression; D005006:Ethnicity; D005192:Family Health; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011446:Prospective Studies; D012044:Regression Analysis; D012307:Risk Factors
Coronary calcium; Family history; Subclinical atherosclerosis