The impact of family history on the presentation and clinical outcome of coronary heart disease : data from the Korea acute myocardial infarction registry

Abstract

Background Familial history (FHx) of coronary heart disease (CHD) is well-known risk factor of CHD. However, the prognostic implication of FHx has not been established clearly in the patients with acute myocardial infarction (AMI).Methods 11,612 patients (male 8,132 (70%), age 63±13 years) with first-onset AMI during Nov 2005 to June 2008 in nationwide prospective, multicenter, online registry (Korea AMI registry: KAMIR) were analyzed. Clinical characteristics and outcome (cardiac death and composite major cardiac adverse events (MACEs)) were assessed according to FHx.Results The patients with FHx (FHx+) were younger and included more male patients. In male patients, FHx+ included more current smokers and individuals with poor lipid profile. In overall patients, after adjustment using Cox proportional hazard model, FHx was related to composite MACEs (hazard ratio (HR) 1.41, p=0.009) and cardiac death (HR 1.56, p=0.080). The poor prognostic implication of family history was more augmented in female and low-risk subset of patients. Significance of interaction was found between male and female patients for composite MACEs (p-value for interaction = 0.057), and between patients with more risk factors (≥2 risk factors) and who with fewer risk factors for cardiac deaths (p- value for interaction = 0.008).Conclusions FHx might be an independent prognostic predictor, especially in female and low-risk subset of patients.