Abstract 14965: Subclinical Coronary Plaque Volumes Are Associated With the Strength of Sibling History in Families With Early-Onset Coronary Disease
Background: A sibling history of early onset coronary artery disease (CAD) is a potent risk factor for future clinically manifest CAD. We examined whether healthy persons from families with early onset CAD, without known CAD themselves, but with a greater number of siblings affected with CAD (strong sib history, defined as ≥50% of siblings in the family) have higher subclinical coronary plaque volumes compared to those with a lesser sib history (only the proband or <50% of siblings affected in the family).
Methods: Apparently healthy participants in GeneSTAR (N=338) with at least one affected sibling with CAD <60 years of age provided pedigree and family history information and were screened for CAD risk factors, and coronary plaque using advanced dual-source CT angiography. Non-calcified and calcified plaque volumes (mm3) were quantified using automated methods and summed for total plaque volume (TP). A multivariate GEE regression model controlled for age, sex, race, current smoking, hypertension, diabetes, LDL cholesterol, statin use, and within family correlations.
Results: Subjects were 58.9±7.4 years of age (range 36 to 74); 55% female; 36% African American. Subjects with a strong sibling history (n=49) were 3.0 times (95% CI 1.3 - 6.6) more likely to have any coronary plaque and had markedly greater volumes of all forms of plaque than those with a lesser sibling history (n=289) (Table). A strong sibling history remained a significant independent predictor of TP volume (p=0.05) when adjusted for all other variables.
Conclusion: Apparently healthy persons with the strongest sibling history have greater subclinical coronary plaque volumes than those with fewer siblings affected with CAD. These results emphasize the importance of screening for complete sibling history in order to identify individuals in whom aggressive primary prevention interventions would likely be most beneficial.
- © 2013 by American Heart Association, Inc.