Cardiovascular Family History Increases the Risk of Disease Recurrence After a First Myocardial Infarction

Background Family history of atherosclerotic cardiovascular disease (ASCVD) is easily accessible and captures genetic cardiovascular risk, but its prognostic value in secondary prevention is unknown. Methods and Results We followed 25 615 patients registered in SWEDEHEART (Swedish Web‐System for Enhancement and Development of Evidence‐Based Care in Heart Disease Evaluated According to Recommended Therapies) from their 1‐year revisit after a first‐time myocardial infarction during 2005 to 2013, until December 31, 2018. Data on relatives, diagnoses and socioeconomics were extracted from national registers. The association between family history and recurrent ASCVD was studied with Cox proportional‐hazard regression, adjusting for risk factors and socioeconomics. A family history of ASCVD was defined as hospitalization due to myocardial infarction, angina with coronary revascularization, stroke, or cardiovascular death in ≥1 parent or full sibling, with early‐onset defined as disease‐onset before 55 years in men and 65 in women. The additional discriminatory value of family history to Thrombolysis in Myocardial Infarction Risk Score for Secondary Prevention was assessed with Harrell’s C‐index difference and reclassification was studied with continuous net reclassification improvement. Family history of early‐onset ASCVD in ≥1 first‐degree relative was present in 2.3% and was associated with recurrent ASCVD (hazard ratio [HR] 1.31; 95% CI, 1.17–1.47), fully adjusted for risk factors (HR, 1.22; 95% CI, 1.05–1.42). Early‐onset family history improved the discriminatory ability of the Thrombolysis in Myocardial Infarction Risk Score for Secondary Prevention, with Harrell’s C improving 0.003 points (95% CI, 0.001–0.005) from initial 0.587 (95% CI, 0.576–0.595) and improved reclassification (continuous net reclassification improvement 2.1%, P <0.001). Conclusions Family history of early‐onset ASCVD is associated with recurrent ASCVD after myocardial infarction, independently of traditional risk factors and improves secondary risk prediction. This may identify patients to target for intensified secondary prevention.

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Cardiovascular family history increases the risk of disease recurrence after a first myocardial infarction

European Heart Journal ◽

10.1093/ehjci/ehaa946.2979 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

A Wahrenberg ◽

P Magnusson ◽

R Kuja-Halkola ◽

H Habel ◽

K Hambraeus ◽

...

Keyword(s):

Risk Factors ◽

Myocardial Infarction ◽

Family History ◽

Cardiovascular Events ◽

Cardiovascular Death ◽

Funding Source ◽

History Of ◽

First Time ◽

Early Family

Abstract Background Despite recent advances in secondary prevention, recurrent cardiovascular events are common after a myocardial infarction (MI). It has been reported that genetic risk scores may predict the risk of recurrent cardiovascular events. Although patient-derived family history is a composite of both genetic and environmental heritability of atherosclerotic cardiovascular disease (ASCVD), it is an easily accessible information compared to genetically based risk models but the association with recurrent events is unknown. Purpose To evaluate whether a register-verified family history of ASCVD is associated with recurrent cardiovascular events (rASCVD) in patients after a first-time MI. Methods We included patients with a first-time MI during 2005 – 2014, registered in the SWEDEHEART SEPHIA registry and without prior ASCVD. Follow-up was available until Dec 31st, 2018. Data on relatives, diagnoses and prescriptions were extracted from national registers. A family history of ASCVD was defined as a register-verified hospitalisation due to MI, angina with coronary revascularization procedures, stroke or cardiovascular death in any parent. Early history was defined as such an event before the age of 55 years in fathers and 65 years in mothers. The association between family history and a composite outcome including recurrent MI, angina requiring acute revascularization, ischaemic stroke and cardiovascular death during follow-up was studied with Cox proportional hazard regression with time from SEPHIA registry completion as underlying time-scale, adjusted for age with splines, gender and year of SEPHIA registry. Regression models were then further adjusted for hypertension, diabetes, smoking and for a subset of patients, LDL-cholesterol (LDL_C) at time of first event. Results Of 25,615 patients, 2.5% and 32.1% had an early and ever-occurring family history of ASCVD, respectively. Patients with early family history were significantly younger than other patients and were more likely to be current smokers and have a higher LDL-C (Median (IQR) 3.5 (1.1) vs 3.3 (1.1) mmol/L). In total, 3,971 (15.5%) patients experienced the outcome. Early family history of ASCVD was significantly associated with rASCVD (Hazard ratio (HR) 1.52, 95% confidence interval (CI) 1.23–1.87), and the effect was sustained when adjusted for cardiovascular risk factors (HR 1.48, 95% CI 1.20–1.83) and LDL-C (HR 1.35, 95% CI 1.04–1.74). Ever-occurring family history was weakly associated with ASCVD (HR 1.09, 95% CI 1.02 – 1.17) and the association remained unchanged with adjustments for risk factors. Conclusions Early family history of cardiovascular disease is a potent risk factor for recurrent cardiovascular events in a secondary prevention setting, independent of traditional risk factors including LDL-C. This is a novel finding and these patients may potentially benefit from intensified secondary preventive measures after a first-time MI. Funding Acknowledgement Type of funding source: Private grant(s) and/or Sponsorship. Main funding source(s): This work was funded by grants from The Swedish Heart and Lung Association

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Serum Uric Acid as a Prognostic Factor of Acute Myocardial Infarction in Hospitalized Patients

TAJ Journal of Teachers Association ◽

10.3329/taj.v34i1.54902 ◽

2021 ◽

Vol 34 (1) ◽

pp. 26-32

Author(s):

Md Amzad Hossain Sardar ◽

Md Khalilur Rahman ◽

Md Mahidul Alam ◽

Md Aminul Hasan ◽

Ashoke Sarker ◽

...

Keyword(s):

Risk Factors ◽

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Uric Acid ◽

Family History ◽

Serum Uric Acid ◽

Acid Level ◽

Serum Uric Acid Level ◽

High Serum ◽

History Of

Background: Among non-communicable diseases, acute myocardial infarction (AMI) is a common killer of people in the world. The management of AMI patients is one of the major challenges in the field of cardiology. Uric acid has several effects of potential interest in cardiovascular disease. There are some markers indicating an unfavorable prognosis in AMI patients. Uric acid is one of the markers that have been evaluated in research. Objective: The aim of this study was to assess the association between serum uric acid level and in-hospital outcomes of AMI patients. Patients and methods: This longitudinal descriptive study was conducted over 115 AMI patients in the Cardiology Unit of Rajshahi Medical College Hospital during the period of January 2015 to December 2016. Baseline characteristics such as age, sex, BMI, BP, RBS, risk factors (hypertension, DM, smoking, family history of IHD, dyslipidemia), and outcomes of AMI patients (acute LVF, arrhythmia, conduction block, cardiogenic shock, death) were recorded. We measured the serum uric acid of this patient at admission. Results: The mean age of patients was 52.83±10.71 years. Out of 115 patients, 83.5% were male, and 16.5% were female. Among the risk factors, 65.2% of patients had HTN, 20.9% DM, 64.3% smoking, 16.5% family history of IHD, and 47.8% dyslipidemia. Out of 115, 35.7% of patients demonstrated high serum uric acid. In outcomes of AMI patients, acute LVF 24.4% (p=0.031) and death 12.2% (p=0.041) were significantly higher in patients with high serum uric acid levels. Conclusion: Significant association was found between high serum uric acid level and in-hospital outcomes of AMI patients. So, estimation of serum uric acid may offer an inexpensive, quick, and non-invasive method for identifying such high-risk patients. TAJ 2021; 34: No-1: 26-32

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The Characteristics of Risk Factors in Chinese Young Women with Acute Coronary Syndrome

10.21203/rs.3.rs-19763/v1 ◽

2020 ◽

Author(s):

Ruifang Liu ◽

Fangxing Xu ◽

Yujie Zhou ◽

Tongku Liu

Keyword(s):

Risk Factors ◽

Family History ◽

Young Women ◽

Early Onset ◽

Young Female ◽

Cardiac Insufficiency ◽

Control Group ◽

Significant Difference ◽

Gynecological Diseases ◽

History Of

Abstract Background In recent years, the prevalence rate of ACS in Chinese young women has been increasing significantly, becoming the main cause of death in young female. This study aimed to investigate the characteristics and difference of risk factors in Chinese young women with ACS and to provide references for ACS prevention and treatment. Methods A 1:1 case-control study was conducted to evaluate risk factors of 415 young female patients with ACS (ACS group) who underwent PCI treatment and 415 young female cases without ACS (control group) who were hospitalized and confirmed by coronary angiography to exclude coronary heart disease from January 2010 to August 2016. The average age of the cases in the two groups was respectively (40.77±4.02) years-old and (40.57±4.01) years-old (P> 0.05). Results The risk factors in ACS group were overweight (64.10%), hypertension (49.88%), hyperlipidemia (35.66%), diabetes (23.37%), depression or anxiety disorder (16.62%), gynecological diseases (16.39%), Hyperuricemia (15.18%), family history of early onset coronary heart disease (14.94%), hyperhomocysteinemia (11.33%), hypothyroidism(14.96%), hypercholesterolemia (8.43%) and high c-reactive protein (7.47%), and were statistically significant difference (P<0.01) compared with that of control group. The average number of risk factors per case in ACS group was significantly more than that of control groups (P<0.01). There was a statistically significant difference in the number of combined risk factors of the overweight cases compared between two groups (P<0.01). Regression analysis showed that hyperlipidemia, hyperhomocysteinemia, overweight（obesity）, high CRP, hypertension, hypothyroidism, gynecological diseases, depression or anxiety, cardiac insufficiency, hypercholesterolemia, diabetes, oral contraceptives, family history of early onset CHD, and autoimmune diseases were independent risk factors (P<0.01). The bivariate correlation analysis between CRP level and age was r= -0.158 (P<0.01). This result showed the younger ACS patient is the higher serum CRP. Conclusion The independent risk factors of ACS in young women are hyperlipidemia, hyperhomocysteinemia, overweight, high CRP, hypertension, hypothyroidism, gynecological diseases, depression or anxiety, cardiac insufficiency, hypercholesterolemia, diabetes, oral contraceptives, family history of early onset CHD, and autoimmune diseases. The co-existence of multiple risk factors is the main cause suffering from ACS in young women.

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P990Assessment of clinical risk factors for all-cause mortality among hypertrophic cardiomyopathy patients with ICDs

European Heart Journal ◽

10.1093/eurheartj/ehz747.0583 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

S Mielczarek ◽

P Syska ◽

M Lewandowski ◽

A Przybylski ◽

M Sterlinski ◽

...

Keyword(s):

Risk Factors ◽

Heart Failure ◽

Family History ◽

Secondary Prevention ◽

Positive Family History ◽

Left Ventricular ◽

Icd Implantation ◽

All Cause Mortality ◽

History Of ◽

End Stage

Abstract Introduction According to the literature, the annual mortality rate of hypertrophic cardiomyopathy (HCM) patients is estimated to 1–2%. Sudden cardiac death (SCD), heart failure and thromboembolism are the main causes of death among this population. Patients at high risk for SCD, identified using HCM risk score, are qualified for ICD implantation. Unfortunately for clinicians, there is no validated model or statistical tool for assessment of the risk of mortality within the HCM patients with ICDs. Purpose The aim of this study was to determine the main risk factors of all- cause mortality in HCM patients with ICDs. Methods The long-term follow-up of group of 104 consecutive patients with HCM, who had the ICD implanted between 1996 and 2006 in tertiary reference clinical unit was performed. Twenty patients who died during observation were the subject of the current analysis. ICD was implanted for primary (n=16) and secondary (n=4) prevention of SCD within this subpopulation. Analysis were performed for mentioned below potential risk factors: age at the time of implantation, syncopes, family history of SCD, atrial fibrillation/supraventricular tachycardia, decreased left ventricular ejection fraction (LVEF), non-sustained ventricular tachycardia (nsVT), maximum left ventricular wall thickness, abnormal exercise blood pressure response, left ventricular outflow tract obstruction. Results The average time of survival since ICD implantation was 8,5±4,6 years. Decreased LVEF (Wald chi2 4,57; p=0,033), secondary prevention (Wald chi2 8,57; p=0,003), family history of SCD (Wald chi2 4,93; p=0,026) and episodes of nsVT (Wald chi2 3,49; p=0,062) are the clinical risk factors that significantly affect the time of survival. The probability of death, expressed as Hazard Ratio, was 27-fold higher in secondary prevention group (HR=27,18), almost 10-fold higher in patients with positive family history of SCD (HR=9,74) and 3,7-fold higher when nsVT was detected. The cause of death was established in 16/20 patients. In 15 cases, these were deaths from cardiovascular causes: end-stage heart failure (8), complications of heart transplantation or circulatory support (4), SCD (1) and other cardiovascular (2). Conclusion Secondary prevention, positive family history of SCD, nsVT and decreased LVEF seem to be the most significant risk factors associated with all- cause mortality in HCM patients with ICDs. Despite the ICD implantation, subpopulation studied had poor prognosis with high incidence of progression to end-stage heart failure. Further studies to create validated model for assessment of death risk in long-term observation of patients with HCM after ICD implantation are required.

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HLA DQ2 HAPLOTYPE, EARLY ONSET OF GRAVES DISEASE, AND POSITIVE FAMILY HISTORY OF AUTOIMMUNE DISORDERS ARE RISK FACTORS FOR DEVELOPING CELIAC DISEASE IN PATIENTS WITH GRAVES DISEASE

Endocrine Practice ◽

10.4158/ep15700.or ◽

2015 ◽

Vol 21 (9) ◽

pp. 993-1000 ◽

Cited By ~ 2

Author(s):

Piotr Miskiewicz ◽

Agata Gos-Zajac ◽

Alina Kurylowicz ◽

Teresa Maria Plazinska ◽

Maria Franaszczyk ◽

...

Keyword(s):

Risk Factors ◽

Celiac Disease ◽

Family History ◽

Early Onset ◽

Positive Family History ◽

Autoimmune Disorders ◽

Graves Disease ◽

History Of ◽

Hla Dq2

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A logistic regression analysis of risk factors in ME/CFS pathogenesis

BMC Neurology ◽

10.1186/s12883-019-1468-2 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 1

Author(s):

Eliana M. Lacerda ◽

Keith Geraghty ◽

Caroline C. Kingdon ◽

Luigi Palla ◽

Luis Nacul

Keyword(s):

Risk Factors ◽

Multiple Sclerosis ◽

Regression Analysis ◽

Risk Factor ◽

Family History ◽

Disease Onset ◽

Healthy Controls ◽

Lower Income ◽

Wide Range ◽

History Of

Abstract Background Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a complex disease, whose exact cause remains unclear. A wide range of risk factors has been proposed that helps understanding potential disease pathogenesis. However, there is little consistency for many risk factor associations, thus we undertook an exploratory study of risk factors using data from the UK ME/CFS Biobank participants. We report on risk factor associations in ME/CFS compared with multiple sclerosis participants and healthy controls. Methods This was a cross-sectional study of 269 people with ME/CFS, including 214 with mild/moderate and 55 with severe symptoms, 74 people with multiple sclerosis (MS), and 134 healthy controls, who were recruited from primary and secondary health services. Data were collected from participants using a standardised written questionnaire. Data analyses consisted of univariate and multivariable regression analysis (by levels of proximity to disease onset). Results A history of frequent colds (OR = 8.26, P <= 0.001) and infections (OR = 25.5, P = 0.015) before onset were the strongest factors associated with a higher risk of ME/CFS compared to healthy controls. Being single (OR = 4.41, P <= 0.001), having lower income (OR = 3.71, P <= 0.001), and a family history of anxiety is associated with a higher risk of ME/CFS compared to healthy controls only (OR = 3.77, P < 0.001). History of frequent colds (OR = 6.31, P < 0.001) and infections before disease onset (OR = 5.12, P = 0.005), being single (OR = 3.66, P = 0.003) and having lower income (OR = 3.48, P = 0.001), are associated with a higher risk of ME/CFS than MS. Severe ME/CFS cases were associated with lower age of ME/CFS onset (OR = 0.63, P = 0.022) and a family history of neurological illness (OR = 6.1, P = 0.001). Conclusions Notable differences in risk profiles were found between ME/CFS and healthy controls, ME/CFS and MS, and mild-moderate and severe ME/CFS. However, we found some commensurate overlap in risk associations between all cohorts. The most notable difference between ME/CFS and MS in our study is a history of recent infection prior to disease onset. Even recognising that our results are limited by the choice of factors we selected to investigate, our findings are consistent with the increasing body of evidence that has been published about the potential role of infections in the pathogenesis of ME/CFS, including common colds/flu.

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The Risk Factors of Premature Myocardial Infarction: A Case Control Study in Iran

Global Journal of Health Science ◽

10.5539/gjhs.v8n11p69 ◽

2016 ◽

Vol 8 (11) ◽

pp. 69 ◽

Cited By ~ 1

Author(s):

Mehdi Ehtesham ◽

Ali Akbar Haghdoost ◽

Seyed Vahid Ahmadi Tabatabaei ◽

Hooman Bakhshandeh

Keyword(s):

Risk Factors ◽

Myocardial Infarction ◽

Family History ◽

Case Control Study ◽

Vascular Diseases ◽

Current Smoking ◽

History Of ◽

Premature Myocardial Infarction ◽

Cardio Vascular ◽

Control Study

BACKGROUND: Although, our knowledge about the factors of cardio vascular diseases (CVD) is relatively acceptable, we have few publications about the risk factors of premature CVD particularly from developing countries such as Iran.OBJECTIVES: The present study is aimed to assess the risk of the modifiable risk factors of coronary heart disease (CHD) in the first cardiac attack of patients classified by age to check which risk factors might have a more significant impact to increase the risk of premature myocardial infarction (MI).METHODS: In a case control study, 122 and 266 cases and controls were recruited from one of the main referral centres in Tehran. Cases were those who were hospitalized because of their first myocardial infarction before the ages of 50 and 55 years in males and females respectively, and compared their risk factor profiles with those experienced first MI in higher age. Main independent variables in this study were: the demographic variables, distress, lipid profile, diabetes, smoking, family history of cardio vascular diseases, and physical activity.RESULTS: The results showed that distress (OR= 3.95), minorities (compare to Fars race) (OR= 3.30), higher education (OR= 1.30), family history of hyperlipidaemia (OR=1.89) significantly increased the risk of premature MI. We also found that family history of hypertension (OR=1.35), current smoking versus no smoking (OR=1.60), fast-food consumption (OR=1.48), non-alcoholic beverages (OR= 1.12) had also association with the risk of premature MI but only in crude model. We also found that regular physical activity (OR=0.42), ex-smoker versus current smoking (OR=0.27) and regular consumption of milk (OR=0.73) was protective against premature MI.CONCLUSION: Our findings demonstrate that the effect of most of risk factors were mostly related to their life-style (distress, smoking, physical inactivity and dietary pattern); while family history of diseases was also important.

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Assessment of the relationship between periodontal disease and cardiovascular disorders: a questionnaire-based study

Medicine and Pharmacy Reports ◽

10.15386/cjmed-639 ◽

2016 ◽

Vol 89 (4) ◽

pp. 534-541 ◽

Cited By ~ 1

Author(s):

Anca Ionel ◽

Ondine Lucaciu ◽

Cosmina Bondor ◽

Minodora Moga ◽

Aranka Ilea ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Family History ◽

Periodontal Disease ◽

Sport Activity ◽

Fresh Fruit ◽

Atherosclerotic Cardiovascular Disease ◽

Significant Difference ◽

History Of ◽

Smoking Duration

Background and aims. Periodontitis is an inflammatory disease, characterized by the loss of connective tissue and alveolar bone. There is an increasing evidence that periodontitis is associated with a number of chronic diseases. The aim of this study was to analyze the correlation between periodontitis and certain systemic diseases by identifying their risk factors in a population from North-West Romania.Methods. A questionnaire-based study was conducted on participants ≥45 years of age in 4 dentistry or family medicine practices from the Cluj and Bihor counties, Romania, over a time frame spanning two months. The interviewer-administered questionnaire included 42 items assessing risk factors for periodontal and cardiovascular disease, current diagnostic and medical treatment of the participants, their diet and oral hygiene habits.Results. Of 108 participants included in the study, 63 (58.3%) declared a previous diagnosis of periodontitis. A significant difference was observed between the participants with declared diagnosis of periodontitis (PD+) and participants without declared diagnosis of periodontitis (PD-) for fresh fruit consumption (p=0.01) and increased sport activity (p=0.009). A significant difference between groups was observed in the case of smoking duration (p=0.047), participants with >10 years of smoking were more likely to declare a diagnosis of periodontitis. Also, PD+ participants were more likely to have a family history of periodontal disease (p<0.001). Multivariate analyses suggested periodontitis as a predictive variable for atherosclerotic coronary artery disease with an OR of 4.85 (95% confidence interval 1.01–23.29, p=0.049).Conclusion. Our study found a statistically significant association between periodontal disease and a known family history of periodontal disorders and smoking duration. Daily intake of fresh fruit and increased sport activities were found to be protective factors against periodontal disease, while periodontitis was found as a risk factor for atherosclerotic cardiovascular disease.

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ACUTE MYOCARDIAL INFARCTION;

The Professional Medical Journal ◽

10.29309/tpmj/2014.21.06.2625 ◽

2014 ◽

Vol 21 (06) ◽

pp. 1200-1203

Author(s):

Shahzad Alam Khan ◽

Sohail Safdar ◽

Asna Ijaz ◽

Ijaz-Ul-Haque Taseer

Keyword(s):

Risk Factors ◽

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Family History ◽

Positive Family History ◽

Descriptive Study ◽

Research Centre ◽

Female Ratio ◽

First Degree Relatives ◽

History Of

Objective: To determine the frequency of family history of IHD and related risk factors in the first degree relatives of patients suffered from acute myocardial infarction (AMI). Study Design: Descriptive study. Setting: PMRC Research Centre, Nishtar Medical College, Multan, Cardiology unit Nishtar Hospital Multan and Chaudhry Pervez Elahi Institute of Cardiology, Multan. Duration: One year from July 2011 to June 2012. Material and methods: In this descriptive study 331 patients of AMI of either sex and age ≥ 20 years admitted in Cardiology unit of Nishtar Hospital Multan and Chaudhary Pervez Elahi Institute of Cardiology Multan were registered. For data collection non-probability convenient sampling technique was used. Informed consent was taken from each patient. The information were recorded in a pre-designed questionnaire. The data were analyzed through SPSS-11. Results: Mean age of the study cases was 54.99±11.25 years (Minimum age was 20 years and maximum was 90 years). Two hundred sixty four (79.8%) were male and 67 (20.2%) were female patients and male to female ratio was 3.9:1. Out of these 331 patients 111 (33.6 %) were having positive family history of IHD. In these 111 (33.6 %) cases history of diabetes was seen in 45 (40.5 %), 43(38.8 %) had history of hypertension and history of hyper-cholesterolemia was present in 23 (20.7 %) of cases. Conclusions: The family history of IHD in addition to traditional risk factors such as hypertension, hyperlipidemia, diabetes mellitus and smoking is itself an important risk factor for IHD. Relatives of the young patients with IHD should be considered as high risk group and it calls for close surveillance of their first degree relatives and early intervention. All their family members should be advised life style modification, appropriate management of risk factors and regular follow up of even apparently healthy descendents.

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