Assistant professor of cardiology, fellowship of echocardiography. Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
Introduction- This an in-depth investigation of the relationship between some new aspects of positive family history (FH) of coronary artery disease (CAD) and other risk factors related to CAD in patients with acute myocardial infarction (AMI).
Method- The data of 200 patients with AMI and positive FH of CAD (FH Pos.)- as case group- and 200 AMI patients without FH of CAD -as control group- (FH Neg.) were collected. Information about first and second-degree relatives was obtained, including age, occurrence of MI, and other risk factors related to CAD. We also covered procedures such as coronary angiography (CAG), percutaneous intervention (PCI), and coronary artery bypass grafting (CABG) surgery.
Results- AMI with ST-segment elevation in ECG (69.61% vs. 26.76%), heart block (19.47%. vs. 6.34%), and low EF (mean 43±3.4% vs. 47±35%) were higher in the FH Pos. group than the FH Neg. group. As well as diabetes (42.71% vs. 11.27%), dyslipidemia (42.19% vs. 14%), and hypertension (73.74% vs. 64.79%) in the FH Pos. group were higher than those in the FH Neg. group. CAG (79.9% vs. 39.9%) and CABG (34.8% vs14.79%) were higher in the FH Pos. group (all p values<0.05). More patients in the FH Pos. group were male and younger. In the FH Pos. group, there was 65% positive finding in the second-degree relatives; most of these second-degree relatives came from the father’s side (56%). Also, there were 1.35 times more events in brothers than in sisters.
Conclusion- Subjects with a positive family history of CAD were younger and more susceptible to CAD and needed frequent interventional procedures. Also, there was a difference in the power of various kinds of positive FH. In the FH Pos. arm, there was a stronger relationship between the patient and his/her brothers than with sisters and 56% incidence in the second-degree relatives (especially from the father’s side).