title: Family history of coronary heart disease is more strongly associated with coronary than with carotid atherosclerosis in healthy asymptomatic adults.
abstract: OBJECTIVE
  To investigate the potentially different relationship between family history (FH) of coronary heart disease (CHD) and carotid or coronary atherosclerosis.
  
  
  METHODS
  Asymptomatic healthy Korean adults older than 30 years who received both coronary CTA and carotid USG as part of a self-referred health check-up were retrospectively investigated (N=662). Multivariable logistic regression analysis was employed to investigate the relationship between FH of CHD and either coronary CTA or carotid USG results.
  
  
  RESULTS
  Adjusted for major CVD risk factors, FH of CHD was significantly associated with presence of any plaque in coronary arteries (aOR 2.10, 95% CI 1.07-4.16) and significant coronary stenosis (aOR 4.92, 95% CI 1.58-15.4), but was not associated with presence of any plaque in carotid arteries (aOR 1.27, 95% CI 0.61-2.63) and increased carotid IMT (aOR 1.44, 95% CI 0.40-5.22). Addition of FH of CHD had significant incremental predictive value to models for any coronary plaque (AUC 0.781 vs. 0.786, p=0.0351), and significant coronary stenosis (AUC 0.772 vs. 0.808, p=0.0129), but not for any carotid plaque (AUC 0.748 vs. 0.748, p=0.528), and increased carotid IMT (AUC 0.778 vs. 0.783, p=0.591).
  
  
  CONCLUSIONS
  To our knowledge, our study is the first to show specific comparative evidence that FH of CHD is more strongly associated with coronary than with carotid atherosclerosis. Our results suggest FH of CHD adds predictive value specifically to coronary atherosclerosis, but not carotid atherosclerosis, and suggest the possibility that screening for coronary atherosclerosis (via CAC) among low to intermediate risk asymptomatic adults with FH of CHD may be beneficial, who otherwise would not be screened according to traditional risk algorithms.
authors.affiliation: Department of Family Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
authors.forename: Beomseok
authors.initials: B
authors.lastname: Suh
authors.affiliation: Department of Family Medicine, Seoul National University Hospital, Seoul, Republic of Korea; Health Promotion Center, Seoul National University Hospital, Seoul, Republic of Korea. Electronic address: dwshin.snuh@gmail.com.
authors.forename: Dong Wook
authors.initials: DW
authors.lastname: Shin
authors.affiliation: Cardiovascular Center and Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
authors.forename: Seung-Pyo
authors.initials: SP
authors.lastname: Lee
authors.affiliation: Department of Family Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
authors.forename: Haewon
authors.initials: H
authors.lastname: Lee
authors.affiliation: Department of Family Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
authors.forename: Hyejin
authors.initials: H
authors.lastname: Lee
authors.affiliation: Department of Radiology and Institute of Radiation Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
authors.forename: Eun-Ah
authors.initials: EA
authors.lastname: Park
authors.affiliation: Department of Family Medicine, Seoul National University Hospital, Seoul, Republic of Korea; Health Promotion Center, Seoul National University Hospital, Seoul, Republic of Korea.
authors.forename: BeLong
authors.initials: B
authors.lastname: Cho
mesh_terms: D000328:Adult; D000368:Aged; D019540:Area Under Curve; D058070:Asymptomatic Diseases; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000235:genetics*; D059168:Carotid Intima-Media Thickness; D015897:Comorbidity; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000235:genetics*; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000453:epidemiology; D050171:Dyslipidemias / Q000453:epidemiology; D005192:Family Health; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D050177:Overweight / Q000453:epidemiology; D058226:Plaque, Atherosclerotic / Q000000981:diagnostic imaging / Q000453:epidemiology; D011237:Predictive Value of Tests; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology
keywords: Carotid intima media thickness; Carotid ultrasonography; Coronary artery stenosis; Coronary computed tomography angiography; Family history of coronary heart disease; Subclinical atherosclerosis