Family history of cardiovascular disease as a risk factor for coronary artery disease in adult offspring La storia familiare di malattia cardiovascolare come fattore di rischio di cardiopatia coronarica nella progenie

Family history of cardiovascular disease as a risk factor for coronary artery disease in adult offspring. K. Hoseini, S. Sadeghian, M. Mahmoudian, R. Hamidian, A. Abbasi. Background and aims: There is controversy about the role of positive family history as an independent risk factor for coronary artery disease. The aim of this work was to in- vestigate the influence of family history on presentation of coronary artery disease in adult offspring, and on its severity. Methods: In a retrospective cross-sectional study at Tehran Heart Center (University of Tehran Medical Sci- ences), 6399 patients with established coronary artery dis- ease who underwent coronary angiography for standard in- dications were assessed. Coronary artery disease was de- fined as atherosclerotic involvement of more than 50% in at least one major coronary artery. Results: 953 patients (14.9%) had a verified positive family history of coronary artery disease, of whom 193 pa- tients (20.2%) and 215 patients (22.5%) had paternal and maternal positive history, respectively. The mean age of clinical onset of ischemic heart disease in patients with a positive history was significantly lower than patients with no history (p < 0.001). Left main coronary lesion was signifi- cantly more frequent in patients with positive history (p = 0.017). Multivariate logistic regression analysis demonstrat- ed that presentation of coronary artery disease in the form of acute coronary syndrome was significantly more preva- lent in the background of positive family history (odds ratio, OR = 1.44, 95% confidence interval, CI: 1.14-1.83, p = 0.002), especially above 45 years old. Conclusion: These findings indicate that positive family history is a major risk factor for coronary artery disease which strongly predisposes to the atherosclerotic process at younger ages; therefore, these patients should be evaluated and managed more intensively for other risk factors.