The association of cardiovascular mortality with a first-degree family member history of different cardiovascular diseases
Charbel Gharios1
Mireille Leblebjian2
Samia Mora3
Roger S.Blumenthal4
Miran A.Jaffa2
Marwan M.Refaat5
1.Department of Internal Medicine,Division of Cardiology,American University of Beirut Medical Center,Beirut,Lebanon;Cardiovascular Imaging Research Center,Massachusetts General Hospital and Harvard Medical School,Boston,MA,USA2.Epidemiology and Population Health Department,Faculty of Health Sciences,American University of Beirut,Beirut,Lebanon3.Center for Lipid Metabolomics,Divisions of Preventive and Cardiovascular Medicine,Brigham and Women's Hospital and Harvard Medical School,Boston,MA,USA4.The Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease,Baltimore,MD,USA5.Department of Internal Medicine,Division of Cardiology,American University of Beirut Medical Center,Beirut,Lebanon;Department of Biochemistry and Molecular Genetics,American University of Beirut Faculty of Medicine,Beirut,Lebanon
摘要：OBJECTIVE To investigate which history of cardiovascular disease[coronary heart disease(CHD),stroke,or peripheral arterial disease]in a first-degree family member predicts cardiovascular mortality.METHODS We studied a prospective cohort(the Lipid Research Clinics Prevalence Study)from ten primary care centers across North America.The primary outcome was cardiovascular mortality,assessed using Cox survival models.RESULTS There were 8,646 participants(mean age:47.4±12.1 years,46％women,52％of participants with hyperlipidemia)who were followed up for a mean duration of 19.4±4.9 years.There were 1,851 deaths(21％),including 852 cardiovascular deaths.A paternal,maternal or sibling history of premature CHD(before 60 years)was present in 26％of participants,of stroke in 27％of participants,and of peripheral arterial disease in 24％of participants.After adjusting for risk factors(age,sex,systolic blood pressure,diastolic blood pressure,body mass index,smoking,fasting glucose,low-density lipoprotein cholesterol and triglycerides),only a paternal history of premature or any CHD,a maternal history of diabetes mellitus or premature or any CHD,and a sibling history of premature CHD,hypertension,or hyperlipidemia were individually predictive of cardiovascular mortality.After adjusting for risk factors and the mentioned familial factors,only paternal and maternal histories of CHD,espe-cially before 60 years,remained predictive of cardiovascular mortality,with a somewhat higher association for a maternal history[adjusted hazard ratio(aHR)=1.99,95％CI:1.36-2.92,P＜0.001 for maternal history of premature CHD;aHR=1.52,95％CI:1.10-2.10,P=0.011 for paternal history of premature CHD].Family history of stroke or peripheral arterial disease did not predict cardiovascular mortality.Parental history of premature CHD predicted cardiovascular mortality independently of baseline age(＜60 years and≥60 years),hypertension,or hyperlipidemia and carried more important prognostic value in men rather than wo-men.CONCLUSIONS In this study,a parental history of CHD,especially before 60 years,best predicted cardiovascular mortality.This finding could help more accurately identify high-risk patients who would benefit from preventive strategies.
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论文发表日期：2021-10-28
在线出版日期：2025-08-15（本平台首次上网日期，不代表文献的发表时间）
页数：9( 816-824 )