Key result
A family history of coronary heart disease was independently associated with a 41% increased risk of composite major adverse cardiac events (HR 1.41) in patients with first-onset acute myocardial infarction.
Why the study?
Does a family history of coronary heart disease worsen clinical outcomes in patients presenting with first-onset acute myocardial infarction?
Cohort (n=11,612)
Yes
Does a family history of coronary heart disease worsen clinical outcomes in patients presenting with first-onset acute myocardial infarction?
A family history of coronary heart disease is an independent predictor of poor clinical outcomes, particularly composite MACE, in patients presenting with first-onset acute myocardial infarction.
May identify higher-risk first-onset AMI patients for closer follow-up; leaves open whether family history-guided interventions improve outcomes.
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 (≥ 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.
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Kim et al. (2013) conducted a cohort in First-onset acute myocardial infarction (n=11,612). Family history of coronary heart disease vs. No family history of coronary heart disease was evaluated on Composite major adverse cardiac events (MACEs) including cardiac death, nonfatal MI, and revascularization within 1 year (HR 1.41, 95% CI 1.09-1.82, p=0.009). A family history of coronary heart disease was independently associated with a 41% increased risk of composite major adverse cardiac events (HR 1.41) in patients with first-onset acute myocardial infarction.
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