Clinical profile and impact of family history of premature coronary artery disease on clinical outcomes of patients undergoing primary percutaneous coronary intervention for ST-elevation myocardial infarction: analysis from the HORIZONS-AMI Trial |
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| Institution: | 1. Cardiovascular Research Foundation, New York, NY, USA;2. Columbia University Medical Center, New York, NY, USA;3. Hôpital du Sacré-Coeur de Montréal, Université de Montréal, Montréal, Québec, Canada;4. New York Methodist Hospital, Brooklyn, NY, USA;5. Icahn School of Medicine at Mount Sinai, New York, NY, USA;1. Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, The Key Laboratory of Remodeling-related Cardiovascular Diseases, Ministry of Education, Department of Atherosclerosis, 2 Anzhen Road, ChaoYang District, Beijing 100029, China;2. Department of Radiology, The China–Japan Friendship Hospital, Beijing 100029, China;3. Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, 2 Anzhen Road, Chaoyang District, Beijing 100029, China;4. Department of Imaging, Beijing Anzhen Hospital, Capital Medical University, 2 Anzhen Road, Chaoyang District, Beijing 100029, China;5. Department of Emergency, Beijing Anzhen Hospital, Capital Medical University, 2 Anzhen Road, Chaoyang District, Beijing 100029, China;6. National Engineering Laboratory for Druggable Gene and Protein Screening, Northeast Normal University, Changchun 130024, Jilin, China;7. Beijing Institute of Genomics, Chinese Academy of Sciences, Beijing 100029, China;1. Heart Center, Turku University Hospital, Turku, Finland;2. PET Center, University of Turku, Turku, Finland;3. Division of Clinical Neurosciences, Neurology, Turku University Hospital, Turku, Finland;4. Department of Neurology, University of Turku, Turku, Finland;5. Clinical Research Center, Turku University Hospital, Turku, Finland;6. Public Health, University of Turku, Turku, Finland |
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| Abstract: | Background/PurposeFamily history of coronary artery disease (CAD) is a well-established risk factor of future cardiovascular events. The authors sought to examine the relationship between family history of CAD and clinical profile and prognosis of patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI).Materials/MethodsBaseline features and clinical outcomes at 30 days and at 3 years from 3601 patients with STEMI enrolled in the HORIZONS-AMI trial were compared in patients with and without family history of premature CAD, which was present in 1059 patients (29.4%).ResultsThese patients were younger (median 56.7 vs. 62.1 years, P < 0.0001) and more often current smokers (52.4% vs. 43.5%, P < 0.0001), had more dyslipidemia (47.7% vs. 41.1%, P = 0.0003), less diabetes mellitus (14.1% vs. 17.5%, P = 0.01) and had shorter symptom onset to balloon times (median 213 vs. 225 min, P = 0.02). Patients with a family history of premature CAD had higher rates of final TIMI 3 flow (93.8% vs. 90.6%, P = 0.002), and myocardial blush grade 2 or 3 (83.2% vs. 78.0% P = 0.0008), and fewer procedural complications. Although the unadjusted 30-day and 3-year mortality rates were lower in patients with a family history of premature CAD (1.8% vs. 3.0%, P = 0.046 and 4.8% vs. 7.7%, P = 0.002, respectively), by multivariable analysis the presence of a family history of premature CAD was not an independent predictor of death at 3 years (HR 95%CI] = 1.00 0.70, 1.44], P = 0.98).ConclusionsA family history of premature CAD is not an independent predictor of higher mortality. |
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