Key result
Positive family history of CAD in first STEMI linked to ~90% lower long-term mortality.
Why the study?
Does a positive family history of CAD affect clinical outcomes in patients presenting with a first STEMI?
Cohort (n=1,785)
Does a positive family history of CAD affect clinical outcomes in patients presenting with a first STEMI?
Hazard Ratio: 0.105 (95% CI 0.033–0.33)
p-value: p=<0.001
In patients presenting with a first STEMI, a positive family history of CAD is paradoxically associated with better short-term and long-term outcomes.
BACKGROUND: A positive family history (FHx+) of coronary artery disease (CAD) is a well-known risk factor for the development of coronary pathology in first-degree relatives. We sought to evaluate the association between FHx+ of CAD and clinical outcomes in patients presenting with a first ST-elevation myocardial infarction (STEMI). PATIENTS AND METHODS: A historical cohort study of all patients with a first STEMI, who were admitted to cardiac ICU between 2007 and 2016, was carried out. Univariate and multivariate analyses were carried out to compare patients with or without a FHx+ of CAD. In further analysis, propensity score matching was used to reduce differences in baseline characteristics. RESULTS: The study included 1785 patients, 365 (20%) of whom had FHx+ of CAD. FHx+ was associated with decreased in-hospital major adverse events and long-term mortality rates (hazard ratio=0.208, 95% confidence interval: 0.051-0.857; P=0.03). After propensity score matching, patients with FHx+ had decreased long-term mortality rates (hazard ratio=0.105, 95% confidence interval: 0.033-0.33; P<0.001). CONCLUSION: In this large cohort of patients with STEMI, FHx+ was associated with better short-term and long-term outcomes. Understanding the rule of FHx in patients with STEMI is important to evaluate the prognosis and may help to construct a prediction model for patients admitted to cardiac ICU.
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Preisler et al. (2018) conducted a cohort in first ST-elevation myocardial infarction (STEMI) (n=1,785). Positive family history of coronary artery disease vs. No family history of coronary artery disease was evaluated on long-term mortality rates (HR 0.105, 95% CI 0.033-0.33, p=<0.001). A positive family history of coronary artery disease in patients with a first STEMI was associated with decreased long-term mortality after propensity score matching (HR 0.105; 95% CI 0.033-0.33; P<0.001).
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