BACKGROUND: Premature cardiovascular disease (CVD) is treated in the same way as CVD of advanced age. However, in patients with premature CVD and a family history of CVD, different -possibly genetic- mechanisms may underlie this disease, which current medical treatment is not targeted to. This suggests that subjects with a genetic predisposition to CVD are more likely to have recurrent cardiovascular events. METHODS: We retrospectively investigated 291 patients with premature CVD and assessed the amount of recurrent events according to family history in a follow-up period of 31 years. Premature CVD was defined as an event <51 years for men or <56 for women. We used a Cox proportional hazards model to estimate the relationship between a positive family history and recurrence of cardiovascular events. RESULTS: Patients with recurrent events had more often a positive family history (60.0% vs. 47.1%; p<0.05), were more often smokers (85.2% vs. 70.7%; p<0.05), had more often hypertension (36.3% vs. 23.6%; p<0.05) and had a longer follow-up period (10.0 years vs. 5.4 years; p<0.001) than patients without recurrent events. After adjusting for these differences and modelling time to events, a positive family history was independently associated with recurrent events (Hazard ratio 1.31 (95% confidence intervals (CI) 1.01-1.72; p<0.05)). CONCLUSIONS: Patients with a genetic predisposition for CVD are at risk for recurrent events, after adjusting for risk factors and other confounders. This might imply that in subjects with a genetic predisposition for CVD different pathophysiological mechanisms are active, leading to recurrent events.
BACKGROUND:Premature cardiovascular disease (CVD) is treated in the same way as CVD of advanced age. However, in patients with premature CVD and a family history of CVD, different -possibly genetic- mechanisms may underlie this disease, which current medical treatment is not targeted to. This suggests that subjects with a genetic predisposition to CVD are more likely to have recurrent cardiovascular events. METHODS: We retrospectively investigated 291 patients with premature CVD and assessed the amount of recurrent events according to family history in a follow-up period of 31 years. Premature CVD was defined as an event <51 years for men or <56 for women. We used a Cox proportional hazards model to estimate the relationship between a positive family history and recurrence of cardiovascular events. RESULTS:Patients with recurrent events had more often a positive family history (60.0% vs. 47.1%; p<0.05), were more often smokers (85.2% vs. 70.7%; p<0.05), had more often hypertension (36.3% vs. 23.6%; p<0.05) and had a longer follow-up period (10.0 years vs. 5.4 years; p<0.001) than patients without recurrent events. After adjusting for these differences and modelling time to events, a positive family history was independently associated with recurrent events (Hazard ratio 1.31 (95% confidence intervals (CI) 1.01-1.72; p<0.05)). CONCLUSIONS:Patients with a genetic predisposition for CVD are at risk for recurrent events, after adjusting for risk factors and other confounders. This might imply that in subjects with a genetic predisposition for CVD different pathophysiological mechanisms are active, leading to recurrent events.
Authors: Christopher Labos; Sara C Martinez; Rui Hao Leo Wang; Petra A Lenzini; Louise Pilote; Peter Bogaty; James M Brophy; James C Engert; Sharon Cresci; George Thanassoulis Journal: Atherosclerosis Date: 2015-07-17 Impact factor: 5.162
Authors: Paul W Atkins; Hernán A Perez; J David Spence; Sonia E Muñoz; Luis J Armando; Néstor H García Journal: Arch Med Sci Date: 2019-11-03 Impact factor: 3.318
Authors: Hyuk Sang Kwon; Kee Ho Song; Jae Myung Yu; Dong Sun Kim; Ho Sang Shon; Kyu Jeung Ahn; Sung Hee Choi; Seung Hyun Ko; Won Kim; Kyoung Hwa Lee; Il Seong Nam-Goong; Tae Sun Park Journal: J Obes Metab Syndr Date: 2021-09-30