Carotid Artery Intima-Media Thickness in Young Adults with Family History of Coronary Artery Disease.
BACKGROUND
It is well established that accelerated athero-sclerosis occurs in middle-aged and elderly adults with family history of coronary artery disease (CAD). However similar data on younger population with genetic predisposition is lacking. As identifying and treating this target group at an early stage will help in postponing the disease progression and delay the onset of clinical events later in life.


OBJECTIVE
We undertook the present study to investigate whether structural vascular changes related to atherosclerosis are detectable in healthy young adults with family history of CAD by non-invasive high resolution scan of the carotid artery intima media thickness (CIMT).


METHODS
Fifty healthy young adults of both sexes, aged 18-25 years with family history of CAD were taken as cases and fifty age, sex, body mass index (BMI) and blood pressure matched subjects without family history of CAD served as control. All participants completed a standardized cardiovascular disease risk assessment questionnaire and resting blood pressure, pulse rate and BMI were recorded. None of the subjects were smoker or alcoholic. Both cases and controls were subjected to high resolution B-mode ultrasonographic evaluation of CIMT. Fasting blood samples were drawn for baseline investigations and lipid profile estimation.


RESULTS
Compared to control subjects, cases had increased CIMT (mean of combined sites 0.57 ± 0.08 mm vs 0.46 ± 0.05 mm in controls, p<0.001). Offspring with family history of CAD exhibited an unfavourable lipid profile. We observed a direct association between carotid intima media thickness and triglyceride concentration (Correlation coefficient=0.32). Multiple logistic regression analysis showed family history of CAD to be independent risk factor for CIMT (Odds ratio=5.36, confidence interval 1.84 - 10.53, p=0.003).


CONCLUSIONS
Arterial wall abnormalities are present at an early age in offspring with family history of CAD. Identifying such high risk individuals is feasible with an easy, non-invasive and reproducible technique like CIMT measurement and hence is recommended.
Assistant Professor, Department of Physiology, SRM MCH & RC , Chennai, India .
Kanimozhi
K
Sadasivam
Tutor, Department of Physiology, SRM MCH & RC , Chennai, India .
Poornima
P
Nagarajan
Assistant Professor, Department of Radiology, SRM MCH & RC , Chennai, India .
Indira
I
Durai
Associate Professor, Department of Internal Medicine, SRM MCH & RC , Chennai, India .
Meenakshi
M
Sundari
Professor and HOD, Department of Physiology, SRM MCH & RC , Chennai, India .
Saravanan
S
Ayyavoo
Lecturer, School of Public Health, SRM University , Chennai, India .
Thilagavathi
T
Ramamoorthy
Atherosclerosis; Cardiovascular disease risk; Carotid ultrasound; Familial predisposition