Impact of family history of coronary artery disease in young individuals (from the CONFIRM registry)

Yuka Otaki; Heidi Gransar; Daniel S. Berman; Victor Y. Cheng; Damini Dey; Fay Y. Lin; Stephan Achenbach; Mouaz Al-Mallah; Matthew J. Budoff; Filippo Cademartiri; Tracy Q. Callister; Hyuk Jae Chang; Kavitha Chinnaiyan; Benjamin J.W. Chow; Augustin Delago; Martin Hadamitzky; Joerg Hausleiter; Philipp Kaufmann; Erica Maffei; Gilbert Raff; Leslee J. Shaw; Todd C. Villines; Allison Dunning; James K. Min

doi:10.1016/j.amjcard.2012.12.042

Impact of family history of coronary artery disease in young individuals (from the CONFIRM registry)

Yuka Otaki, Heidi Gransar, Daniel S. Berman, Victor Y. Cheng, Damini Dey, Fay Y. Lin, Stephan Achenbach, Mouaz Al-Mallah, Matthew J. Budoff, Filippo Cademartiri, Tracy Q. Callister, Hyuk Jae Chang, Kavitha Chinnaiyan, Benjamin J.W. Chow, Augustin Delago, Martin Hadamitzky, Joerg Hausleiter, Philipp Kaufmann, Erica Maffei, Gilbert RaffLeslee J. Shaw, Todd C. Villines, Allison Dunning, James K. Min

Department of Internal Medicine

Research output: Contribution to journal › Article › peer-review

48 Citations (Scopus)

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.

Original language	English
Pages (from-to)	1081-1086
Number of pages	6
Journal	American Journal of Cardiology
Volume	111
Issue number	8
DOIs	https://doi.org/10.1016/j.amjcard.2012.12.042
Publication status	Published - 2013 Apr 15

Bibliographical note

Funding Information:
Dr. Achenbach received grant support from Siemens Healthcare, Erlangen, Germany, and Bayer Schering Pharma AG, Berlin, Germany, and has served as a consultant for Servier, Neuilly-sur-Seine, France. Dr. Al-Mallah received support from the American Heart Association, Dallas, Texas; the Blue Cross Blue Shield of Michigan Foundation, Detroit, Michigan; and Astellas Pharma Inc., Tokyo, Japan. Dr. Cademartiri received grant support from GE Healthcare and has served on the speakers' bureau of Bracco, Milan, Italy, and as a consultant for Servier. Dr. Chinnaiyan received grant support from Bayer Schering Pharma AG and Blue Cross Blue Shield Blue Care Michigan, Detroit, Michigan. Dr. Chow received research and fellowship support from GE Healthcare; research support from Pfizer, Inc., New York, New York, and AstraZeneca, Wilmington, Delaware; and educational support from TeraRecon, Foster City, California. Dr. Hausleiter received a research grant from Siemens Medical Systems, Forchheim, Germany. Dr. Maffei received grant support from GE Healthcare. Dr. Kaufmann received institutional research support from GE Healthcare and grant support from the Swiss National Science Foundation, Bern, Switzerland. Dr. Raff received grant support from Siemens Healthcare, Blue Cross Blue Shield Blue Care Michigan, and Bayer Schering Pharma AG. Dr. Min received modest speakers' bureau and medical advisory board compensation and significant research support from GE Healthcare, Milwaukee, Wisconsin.

All Science Journal Classification (ASJC) codes

Cardiology and Cardiovascular Medicine

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10.1016/j.amjcard.2012.12.042

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Otaki, Y., Gransar, H., Berman, D. S., Cheng, V. Y., Dey, D., Lin, F. Y., Achenbach, S., Al-Mallah, M., Budoff, M. J., Cademartiri, F., Callister, T. Q., Chang, H. J., Chinnaiyan, K., Chow, B. J. W., Delago, A., Hadamitzky, M., Hausleiter, J., Kaufmann, P., Maffei, E., ... Min, J. K. (2013). Impact of family history of coronary artery disease in young individuals (from the CONFIRM registry). American Journal of Cardiology, 111(8), 1081-1086. https://doi.org/10.1016/j.amjcard.2012.12.042

@article{638ba45fe6564364a7589c46865d25ff,

title = "Impact of family history of coronary artery disease in young individuals (from the CONFIRM registry)",

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.",

author = "Yuka Otaki and Heidi Gransar and Berman, {Daniel S.} and Cheng, {Victor Y.} and Damini Dey and Lin, {Fay Y.} and Stephan Achenbach and Mouaz Al-Mallah and Budoff, {Matthew J.} and Filippo Cademartiri and Callister, {Tracy Q.} and Chang, {Hyuk Jae} and Kavitha Chinnaiyan and Chow, {Benjamin J.W.} and Augustin Delago and Martin Hadamitzky and Joerg Hausleiter and Philipp Kaufmann and Erica Maffei and Gilbert Raff and Shaw, {Leslee J.} and Villines, {Todd C.} and Allison Dunning and Min, {James K.}",

note = "Funding Information: Dr. Achenbach received grant support from Siemens Healthcare, Erlangen, Germany, and Bayer Schering Pharma AG, Berlin, Germany, and has served as a consultant for Servier, Neuilly-sur-Seine, France. Dr. Al-Mallah received support from the American Heart Association, Dallas, Texas; the Blue Cross Blue Shield of Michigan Foundation, Detroit, Michigan; and Astellas Pharma Inc., Tokyo, Japan. Dr. Cademartiri received grant support from GE Healthcare and has served on the speakers' bureau of Bracco, Milan, Italy, and as a consultant for Servier. Dr. Chinnaiyan received grant support from Bayer Schering Pharma AG and Blue Cross Blue Shield Blue Care Michigan, Detroit, Michigan. Dr. Chow received research and fellowship support from GE Healthcare; research support from Pfizer, Inc., New York, New York, and AstraZeneca, Wilmington, Delaware; and educational support from TeraRecon, Foster City, California. Dr. Hausleiter received a research grant from Siemens Medical Systems, Forchheim, Germany. Dr. Maffei received grant support from GE Healthcare. Dr. Kaufmann received institutional research support from GE Healthcare and grant support from the Swiss National Science Foundation, Bern, Switzerland. Dr. Raff received grant support from Siemens Healthcare, Blue Cross Blue Shield Blue Care Michigan, and Bayer Schering Pharma AG. Dr. Min received modest speakers' bureau and medical advisory board compensation and significant research support from GE Healthcare, Milwaukee, Wisconsin.",

year = "2013",

month = apr,

day = "15",

doi = "10.1016/j.amjcard.2012.12.042",

language = "English",

volume = "111",

pages = "1081--1086",

journal = "American Journal of Cardiology",

issn = "0002-9149",

publisher = "Elsevier Inc.",

number = "8",

}

Otaki, Y, Gransar, H, Berman, DS, Cheng, VY, Dey, D, Lin, FY, Achenbach, S, Al-Mallah, M, Budoff, MJ, Cademartiri, F, Callister, TQ, Chang, HJ, Chinnaiyan, K, Chow, BJW, Delago, A, Hadamitzky, M, Hausleiter, J, Kaufmann, P, Maffei, E, Raff, G, Shaw, LJ, Villines, TC, Dunning, A & Min, JK 2013, 'Impact of family history of coronary artery disease in young individuals (from the CONFIRM registry)', American Journal of Cardiology, vol. 111, no. 8, pp. 1081-1086. https://doi.org/10.1016/j.amjcard.2012.12.042

TY - JOUR

T1 - Impact of family history of coronary artery disease in young individuals (from the CONFIRM registry)

AU - Otaki, Yuka

AU - Gransar, Heidi

AU - Berman, Daniel S.

AU - Cheng, Victor Y.

AU - Dey, Damini

AU - Lin, Fay Y.

AU - Achenbach, Stephan

AU - Al-Mallah, Mouaz

AU - Budoff, Matthew J.

AU - Cademartiri, Filippo

AU - Callister, Tracy Q.

AU - Chang, Hyuk Jae

AU - Chinnaiyan, Kavitha

AU - Chow, Benjamin J.W.

AU - Delago, Augustin

AU - Hadamitzky, Martin

AU - Hausleiter, Joerg

AU - Kaufmann, Philipp

AU - Maffei, Erica

AU - Raff, Gilbert

AU - Shaw, Leslee J.

AU - Villines, Todd C.

AU - Dunning, Allison

AU - Min, James K.

N1 - Funding Information: Dr. Achenbach received grant support from Siemens Healthcare, Erlangen, Germany, and Bayer Schering Pharma AG, Berlin, Germany, and has served as a consultant for Servier, Neuilly-sur-Seine, France. Dr. Al-Mallah received support from the American Heart Association, Dallas, Texas; the Blue Cross Blue Shield of Michigan Foundation, Detroit, Michigan; and Astellas Pharma Inc., Tokyo, Japan. Dr. Cademartiri received grant support from GE Healthcare and has served on the speakers' bureau of Bracco, Milan, Italy, and as a consultant for Servier. Dr. Chinnaiyan received grant support from Bayer Schering Pharma AG and Blue Cross Blue Shield Blue Care Michigan, Detroit, Michigan. Dr. Chow received research and fellowship support from GE Healthcare; research support from Pfizer, Inc., New York, New York, and AstraZeneca, Wilmington, Delaware; and educational support from TeraRecon, Foster City, California. Dr. Hausleiter received a research grant from Siemens Medical Systems, Forchheim, Germany. Dr. Maffei received grant support from GE Healthcare. Dr. Kaufmann received institutional research support from GE Healthcare and grant support from the Swiss National Science Foundation, Bern, Switzerland. Dr. Raff received grant support from Siemens Healthcare, Blue Cross Blue Shield Blue Care Michigan, and Bayer Schering Pharma AG. Dr. Min received modest speakers' bureau and medical advisory board compensation and significant research support from GE Healthcare, Milwaukee, Wisconsin.

PY - 2013/4/15

Y1 - 2013/4/15

N2 - 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.

AB - 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.

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DO - 10.1016/j.amjcard.2012.12.042

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SN - 0002-9149

VL - 111

SP - 1081

EP - 1086

JO - American Journal of Cardiology

JF - American Journal of Cardiology

IS - 8

ER -

Impact of family history of coronary artery disease in young individuals (from the CONFIRM registry)

Abstract

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