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Impact of Family History of Coronary Artery Disease in Young Individuals (from the CONFIRM Registry)

Authors
 Yuka Otaki ; Heidi Gransar ; James K. Min ; Allison Dunning ; Todd C. Villines ; Leslee J. Shaw ; Gilbert Raff ; Erica Maffei ; Philipp Kaufmann ; Joerg Hausleiter ; Martin Hadamitzky ; Augustin Delago ; Benjamin J.W. Chow ; Kavitha Chinnaiyan ; Hyuk-Jae Chang ; Tracy Q. Callister ; Filippo Cademartiri ; Matthew J. Budoff ; Mouaz Al-Mallah ; Stephan Achenbach ; Fay Y. Lin ; Damini Dey ; Victor Y. Cheng ; Daniel S. Berman 
Citation
 American Journal of Cardiology, Vol.111(8) : 1081~1086, 2013 
Journal Title
 American Journal of Cardiology 
ISSN
 0002-9149 
Issue Date
2013
Abstract
Although family history (FH) of coronary artery disease (CAD) is considered a risk factor for future cardiovascular events, the prevalence, extent, severity, and prognosis of young patients with FH of CAD have been inadequately studied. From 27,125 consecutive patients who underwent coronary computed tomographic angiography, 6,308 young patients (men aged <55 years and women aged <65 years) without known CAD were identified. Obstructive CAD was defined as >50% stenosis in a coronary artery >2 mm diameter. Risk-adjusted logistic regression, Kaplan-Meier, and Cox proportional-hazards models were used to compare patients with and without FH of CAD. Compared with subjects without FH of CAD, those with FH of CAD (FH+) had higher prevalences of any CAD (40% vs 30%, p <0.001) and obstructive CAD (11% vs 7%, p <0.001), with multivariate odds of FH+ increasing the likelihood of obstructive CAD by 71% (p <0.001). After a mean follow-up period of 2 ± 1 years (42 myocardial infarctions and 39 all-cause deaths), FH+ patients experienced higher annual rates of myocardial infarction (0.5% vs 0.2%, log-rank p = 0.001), with a positive FH the strongest predictor of myocardial infarction (hazard ratio 2.6, 95% confidence interval 1.4 to 4.8, p = 0.002). In conclusion, young FH+ patients have higher presence, extent, and severity of CAD, which are associated with increased risk for myocardial infarction. Compared with other clinical CAD risk factors, positive FH in young patients is the strongest clinical predictor of future unheralded myocardial infarction
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/87314
DOI
10.1016/j.amjcard.2012.12.042
Appears in Collections:
1. 연구논문 > 1. College of Medicine > Dept. of Internal Medicine
Yonsei Authors
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Link
 http://www.sciencedirect.com/science/article/pii/S0002914912026458
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