title: Clinical profile and impact of family history of premature coronary artery disease on clinical outcomes of patients undergoing primary percutaneous coronary intervention for ST-elevation myocardial infarction: analysis from the HORIZONS-AMI Trial.
abstract: OBJECTIVE
  Family history of coronary artery disease (CAD) is a well-established risk factor of future cardiovascular events. The authors sought to examine the relationship between family history of CAD and clinical profile and prognosis of patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI).
  
  
  METHODS
  Baseline features and clinical outcomes at 30 days and at 3 years from 3601 patients with STEMI enrolled in the HORIZONS-AMI trial were compared in patients with and without family history of premature CAD, which was present in 1059 patients (29.4%).
  
  
  RESULTS
  These patients were younger (median 56.7 vs. 62.1years, P<0.0001) and more often current smokers (52.4% vs. 43.5%, P<0.0001), had more dyslipidemia (47.7% vs. 41.1%, P=0.0003), less diabetes mellitus (14.1% vs. 17.5%, P=0.01) and had shorter symptom onset to balloon times (median 213 vs. 225 min, P=0.02). Patients with a family history of premature CAD had higher rates of final TIMI 3 flow (93.8% vs. 90.6%, P=0.002), and myocardial blush grade 2 or 3 (83.2% vs. 78.0% P=0.0008), and fewer procedural complications. Although the unadjusted 30-day and 3-year mortality rates were lower in patients with a family history of premature CAD (1.8% vs. 3.0%, P=0.046 and 4.8% vs. 7.7%, P=0.002, respectively), by multivariable analysis the presence of a family history of premature CAD was not an independent predictor of death at 3 years (HR [95%CI]=1.00 [0.70, 1.44], P=0.98).
  
  
  CONCLUSIONS
  A family history of premature CAD is not an independent predictor of higher mortality.
authors.affiliation: Cardiovascular Research Foundation, New York, NY, USA.
authors.forename: Konstanze
authors.initials: K
authors.lastname: Ertelt
authors.affiliation: Cardiovascular Research Foundation, New York, NY, USA; Columbia University Medical Center, New York, NY, USA; Hôpital du Sacré-Coeur de Montréal, Université de Montréal, Montréal, Québec, Canada. Electronic address: pg2295@columbia.edu.
authors.forename: Philippe
authors.initials: P
authors.lastname: Généreux
authors.affiliation: Cardiovascular Research Foundation, New York, NY, USA.
authors.forename: Gary S
authors.initials: GS
authors.lastname: Mintz
authors.affiliation: Cardiovascular Research Foundation, New York, NY, USA; New York Methodist Hospital, Brooklyn, NY, USA.
authors.forename: Sorin J
authors.initials: SJ
authors.lastname: Brener
authors.affiliation: Cardiovascular Research Foundation, New York, NY, USA; Columbia University Medical Center, New York, NY, USA.
authors.forename: Ajay J
authors.initials: AJ
authors.lastname: Kirtane
authors.affiliation: Cardiovascular Research Foundation, New York, NY, USA.
authors.forename: Thomas C
authors.initials: TC
authors.lastname: McAndrew
authors.affiliation: Cardiovascular Research Foundation, New York, NY, USA.
authors.forename: Dominic P
authors.initials: DP
authors.lastname: Francese
authors.affiliation: Cardiovascular Research Foundation, New York, NY, USA.
authors.forename: Ori
authors.initials: O
authors.lastname: Ben-Yehuda
authors.affiliation: Cardiovascular Research Foundation, New York, NY, USA; Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Roxana
authors.initials: R
authors.lastname: Mehran
authors.affiliation: Cardiovascular Research Foundation, New York, NY, USA; Columbia University Medical Center, New York, NY, USA.
authors.forename: Gregg W
authors.initials: GW
authors.lastname: Stone
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000379:methods; D002986:Clinical Trials as Topic; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000601:surgery*; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000097:blood; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery*; D062645:Percutaneous Coronary Intervention / Q000379:methods; D011379:Prognosis; D012307:Risk Factors; D015607:Stents; D016896:Treatment Outcome
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
keywords: Coronary artery disease; Heredity; Percutaneous coronary intervention