Abstract 1645: Relationship of Premature Family History of Coronary Heart Disease With Coronary Artery Calcium Progression in the Multi-Ethnic Study of Atherosclerosis
Background: A family history (FamHx) of premature coronary heart disease (CHD) is an independent risk factor for CHD events. In this study we aimed to assess whether FamHx of both premature and late onset CHD is associated with incident coronary artery calcium (CAC) and with progression of CAC scores in the Multi-Ethnic Study of Atherosclerosis (MESA).
Methods: The final study population consisted of 5,099 individuals (61±10 years, 47% males), 2,466 (48%) with no FamHx of CHD, 1,002 (20%) with premature onset FamHx of CHD, and 1,631 (32%) with late onset FamHx of CHD. FamHx of premature CHD was defined as CHD in a male first degree relative before age 55 or in a female first degree relative before age 65. CHD reported after these age cutoffs was considered of late onset. Incident CAC was defined as detectable CAC at the follow-up exams (exam 2– 4) among those free of CAC at the baseline exam. The independent relation of FamHx of CHD with incident CAC was assessed by relative risk (RR) regression, using a generalized linear model. Among those with CAC>0 at baseline, multivariable adjusted median linear regression was employed to assess the relationship of FamHx of CHD with absolute CAC change. We excluded 1,467 individuals who could not provide information on FamHx of CHD and 248 individuals with missing CAC information at follow-up examination.
Results: Of 2,645 (52%) individuals with no detectable CAC at baseline, 20% (n=527) developed CAC over a mean follow-up period of 3.1±1.3 years. Table 1⇓ demonstrates that in multivariate adjusted analyses, FamHx of premature onset CHD predicted incident CAC, whereas FamHx of both premature and late onset CHD were significantly associated with a higher progression of CAC scores among those with CAC>0 at baseline.
Conclusion: In a population-based multiethnic cohort of asymptomatic, mostly low- and intermediate-risk men and women, FamHx of CHD was associated a higher risk of development and progression of subclinical atherosclerosis.