The Korean journal of internal medicine

The Korean Association of Internal Medicine (대한내과학회)
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Impact of family history on the presentation and clinical outcomes of coronary heart disease: data from the Korea Acute Myocardial Infarction Registry

  • Kim, Choongki (Severance Cardiovascular Center, Yonsei University Health System) ;
  • Chang, Hyuk-Jae (Severance Cardiovascular Center, Yonsei University Health System) ;
  • Cho, Iksung (Severance Cardiovascular Center, Yonsei University Health System) ;
  • Sung, Ji Min (CHA University Graduate School of Health and Welfare, Seongnam) ;
  • Choi, Donghoon (Severance Cardiovascular Center, Yonsei University Health System) ;
  • Jeong, Myung Ho (The Heart Center, Chonnam National University Hospital) ;
  • Jang, Yang Soo (Severance Cardiovascular Center, Yonsei University Health System) ;
  • Korea Acute Myocardial Infarction Registry Investigators, Korea Acute Myocardial Infarction Registry Investigators (Korea Acute Myocardial Infarction Registry Investigators)
  • Received : 2012.05.28
  • Accepted : 2012.11.08
  • Published : 2013.09.01
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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 $63{\pm}13$ 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 (${\geq}2$ 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.

Keywords

References

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