Korean J Intern Med.  2013 Sep;28(5):547-556. 10.3904/kjim.2013.28.5.547.

Impact of family history on the presentation and clinical outcomes of coronary heart disease: data from the Korea Acute Myocardial Infarction Registry

• Kim C
• Chang HJ
• Cho I
• Sung JM
• Choi D
• Jeong MH
• Jang YS
• Other Korea Acute Myocardial Infarction Registry Investigators

• KMID: 1780102
• DOI: http://doi.org/10.3904/kjim.2013.28.5.547

Abstract

BACKGROUND/AIMS
Family history (FHx) of coronary heart disease (CHD) is a well-known risk factor for CHD. However, the prognostic implication of FHx has not been established clearly in patients with acute myocardial infarction (AMI).
METHODS
In total, 11,612 patients (8,132 males [70%], age 63 +/- 13 years) with first-onset AMI between November 2005 and June 2008 in a nationwide, prospective, multicenter, online registry (the Korea AMI Registry) were analyzed. Clinical characteristics and outcomes (cardiac death and major adverse cardiac events [MACEs]) were assessed according to the presence of FHx.
RESULTS
The patients with FHx were younger and included more males. Male patients with FHx included more current smokers and individuals with poor lipid profiles. In all patients, after adjustment using the Cox proportional hazard model, FHx was related to the risk of MACEs (hazard ratio [HR], 1.41; p = 0.009) and cardiac death (HR, 1.56; p = 0.080). The poor prognostic implication of FHx was further augmented in females and a low risk subset of patients. A significant interaction was only found between male and female patients for composite MACEs (p for interaction = 0.057), and between patients with more risk factors (> or = 2 risk factors) and fewer risk factors for cardiac deaths (p for interaction = 0.008).
CONCLUSIONS
FHx may be an independent prognostic predictor, especially in female patients and patients with low-risk profile.

Keyword

Coronary disease; Myocardial infarction; Risk factors; Epidemiology

MeSH Terms

Adult
Aged
Chi-Square Distribution
Coronary Artery Bypass
Coronary Disease/*genetics/mortality/therapy
Female
Genetic Predisposition to Disease
Heredity
Humans
Male
Middle Aged
Multivariate Analysis
Myocardial Infarction/*genetics/mortality/therapy
Pedigree
Percutaneous Coronary Intervention
Prognosis
Proportional Hazards Models
Registries
Republic of Korea/epidemiology
Retrospective Studies
Risk Factors
Sex Factors
Time Factors