BACKGROUND: There is controversy regarding the role of family history (FH) of premature coronary artery disease (CAD) as an independent risk factor for CAD. Herein, we aimed to assess the role of FH of premature CAD in prediction of coronary atherosclerosis shown by multidetector computed tomography (MDCT) coronary angiography. METHODS: We analyzed consecutive subset of 349 patients in whom MDCT coronary angiography was performed for suspected CAD. All patients underwent coronary MDCT imaging using dual-source MDCT scanner. Coronary arteries were evaluated on 16-segment basis, critical CAP was described as luminal narrowing >50%, whereas plaque morphology was assessed on per segment basis. RESULTS: Study population consisted of 202 (57.9%) male and 147 (42.1%) female patients with mean age of 57.8 ± 10.8 years. The presence of CAP was higher in patients with FH of premature CAD in LAD and Cx compared to patients without FH of premature CAD (70.8% vs 58.0%, p=0.013 for LAD; 42.3% vs 30.4%, p=0.021 for Cx; 34.5% vs 29.8%, p=0.348 for RCA).In multinominal logistic regression analysis age, male gender, dyslipidemia and FH of premature CAD seemed significant predictors of primarily noncalcified CAP(OR:1.17, 95% CI:1.07-1.15, p<0.001; OR:0.19, 95% CI:0.09-0.38, p<0.001; OR:2.26, 95% CI:1.21-4.24, p=0.01; OR:3.32, 95% CI:1.74-6.34, p<0.001 respectively) after adjustment for other risk factors. CONCLUSION: Our study results indicate that FH of premature CAD is associated with severity, extent and noncalcified CAP shown by MDCT. Further investigation is needed to clarify the exact diagnostic and prognostic role of MDCT coronary angiography in subjects with positive FH and suspected CAD.
BACKGROUND: There is controversy regarding the role of family history (FH) of premature coronary artery disease (CAD) as an independent risk factor for CAD. Herein, we aimed to assess the role of FH of premature CAD in prediction of coronary atherosclerosis shown by multidetector computed tomography (MDCT) coronary angiography. METHODS: We analyzed consecutive subset of 349 patients in whom MDCT coronary angiography was performed for suspected CAD. All patients underwent coronary MDCT imaging using dual-source MDCT scanner. Coronary arteries were evaluated on 16-segment basis, critical CAP was described as luminal narrowing >50%, whereas plaque morphology was assessed on per segment basis. RESULTS: Study population consisted of 202 (57.9%) male and 147 (42.1%) female patients with mean age of 57.8 ± 10.8 years. The presence of CAP was higher in patients with FH of premature CAD in LAD and Cx compared to patients without FH of premature CAD (70.8% vs 58.0%, p=0.013 for LAD; 42.3% vs 30.4%, p=0.021 for Cx; 34.5% vs 29.8%, p=0.348 for RCA).In multinominal logistic regression analysis age, male gender, dyslipidemia and FH of premature CAD seemed significant predictors of primarily noncalcified CAP(OR:1.17, 95% CI:1.07-1.15, p<0.001; OR:0.19, 95% CI:0.09-0.38, p<0.001; OR:2.26, 95% CI:1.21-4.24, p=0.01; OR:3.32, 95% CI:1.74-6.34, p<0.001 respectively) after adjustment for other risk factors. CONCLUSION: Our study results indicate that FH of premature CAD is associated with severity, extent and noncalcified CAP shown by MDCT. Further investigation is needed to clarify the exact diagnostic and prognostic role of MDCT coronary angiography in subjects with positive FH and suspected CAD.
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