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

• Published in: The Korean journal of internal medicine Vol. 28; no. 5; pp. 547 - 556
• Main Authors: Kim, Choongki, Chang, Hyuk-Jae, Cho, Iksung, Sung, Ji Min, Choi, Donghoon, Jeong, Myung Ho, Jang, Yang Soo
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Association of Internal Medicine 01-09-2013; 대한내과학회
• Subjects: Adult; Aged; Chi-Square Distribution; Coronary Artery Bypass; Coronary Disease - genetics; Coronary Disease - mortality; Coronary Disease - therapy; Female; Genetic Predisposition to Disease; Heredity; Humans; Male; Middle Aged; Multivariate Analysis; Myocardial Infarction - genetics; Myocardial Infarction - mortality; Myocardial Infarction - therapy; Original; Pedigree; Percutaneous Coronary Intervention; Prognosis; Proportional Hazards Models; Registries; Republic of Korea - epidemiology; Retrospective Studies; Risk Factors; Sex Factors; Time Factors; 내과학; Republic of Korea; Myocardial infarction; Coronary disease; Epidemiology; Risk factors
• ISSN: 1226-3303; 2005-6648
• DOI: 10.3904/kjim.2013.28.5.547

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).
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.
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 (≥ 2 risk factors) and fewer risk factors for cardiac deaths (p for interaction = 0.008).
FHx may be an independent prognostic predictor, especially in female patients and patients with low-risk profile.