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Family history of coronary artery disease and adverse clinical outcomes in patients suffering from acute ST-segment elevation myocardial infarction

Preisler, Yoava,*; Ziv-Baran, Tomerb,*; Chorin, Ehudc; Margolis, Giladc; Khoury, Shafikc; Shacham, Yacovc

doi: 10.1097/MCA.0000000000000667
Myocardial Infarction
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SDC

Background A positive family history (FHx+) of coronary artery disease (CAD) is a well-known risk factor for the development of coronary pathology in first-degree relatives. We sought to evaluate the association between FHx+ of CAD and clinical outcomes in patients presenting with a first ST-elevation myocardial infarction (STEMI).

Patients and methods A historical cohort study of all patients with a first STEMI, who were admitted to cardiac ICU between 2007 and 2016, was carried out. Univariate and multivariate analyses were carried out to compare patients with or without a FHx+ of CAD. In further analysis, propensity score matching was used to reduce differences in baseline characteristics.

Results The study included 1785 patients, 365 (20%) of whom had FHx+ of CAD. FHx+ was associated with decreased in-hospital major adverse events and long-term mortality rates (hazard ratio=0.208, 95% confidence interval: 0.051–0.857; P=0.03). After propensity score matching, patients with FHx+ had decreased long-term mortality rates (hazard ratio=0.105, 95% confidence interval: 0.033–0.33; P<0.001).

Conclusion In this large cohort of patients with STEMI, FHx+ was associated with better short-term and long-term outcomes. Understanding the rule of FHx in patients with STEMI is important to evaluate the prognosis and may help to construct a prediction model for patients admitted to cardiac ICU.

aSackler Faculty of Medicine

bDepartment of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine

cDepartment of Cardiology, Tel Aviv Sourasky Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel

*Yoav Preisler and Tomer Ziv-Baran contributed equally to the writing of this article.

Correspondence to Tomer Ziv-Baran, PhD, Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, P.O. Box 39040, Tel Aviv 6997801, Israel Tel: +972 36 405 706; fax: +972 36 409 868; e-mail: zivtome@post.tau.ac.il

Received September 14, 2018

Accepted September 15, 2018

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