De Bacquer D, De Backer G, Kornitzer M, Blackburn H
Department of Public Health, University of Ghent, Belgium.
J Am Coll Cardiol. 1999 May;33(6):1491-8. doi: 10.1016/s0735-1097(99)00067-4.
Here we explore the association between a family history of premature coronary heart disease (CHD) death and ischemic electrocardiogram (ECG) findings in the offspring.
In the general population, signs of ischemia are found on the resting ECG in about 10% of middle-aged men and women. Their independent predictive value for CHD morbidity and mortality has been shown in several studies.
Our results are based on cross-sectional data from three large epidemiological studies performed in Belgium during the past two decades: the Belgian Heart Disease Prevention Project (n = 8,145), the Belgian Interuniversity Research on Nutrition and Health survey (n = 7,625) and the MONICA project (n = 3,193). A parental history of fatal CHD was considered premature if the father died from CHD before age 60 or the mother before age 70. Ischemic ECG findings were defined according to Minnesota Code criteria I(1-3), IV(1-3), V(1-3) or VII1.
Subjects with a parental history of premature CHD death were found to have experienced significantly more frequently symptomatic CHD. After exclusion of symptomatic individuals, no major differences in lifestyle-related risk factors were found between the groups with and without a parental history of premature fatal CHD. After multivariate adjustment for age, smoking, body mass index and sex, the odds ratios (and 95% confidence interval [CI]) for ECG ischemia associated with a positive parental history of premature death were 1.42 (1.10-1.82), 1.47 (1.16-1.88) and 1.37 (0.78-2.41) in the three studies. Additional adjustment for systolic blood pressure, total cholesterol and, if available, lifestyle-related factors did not alter the magnitude of the odds ratios. Overall, in men aged 45 to 64 years, ECG ischemia was significantly more frequent (36% excess) in those with positive parental history.
Subjects in whom one or both parents died prematurely from cardiac-related diseases have signs of ischemia more frequently on their electrocardiogram, and this is independent of other risk factors.
在此我们探讨早发性冠心病（CHD）死亡家族史与后代缺血性心电图（ECG）表现之间的关联。
在普通人群中，约10%的中年男性和女性静息心电图上有缺血迹象。几项研究已表明它们对冠心病发病率和死亡率具有独立预测价值。
我们的结果基于过去二十年在比利时进行的三项大型流行病学研究的横断面数据：比利时心脏病预防项目（n = 8145）、比利时大学间营养与健康研究调查（n = 7625）以及莫尼卡项目（n = 3193）。如果父亲在60岁之前死于冠心病或母亲在70岁之前死于冠心病，则认为有致命冠心病的家族史为早发性。缺血性心电图表现根据明尼苏达编码标准I(1 - 3)、IV(1 - 3)、V(1 - 3)或VII1来定义。
有早发性冠心病死亡家族史的受试者患症状性冠心病的频率显著更高。排除有症状的个体后，有和没有早发性致命冠心病家族史的两组在与生活方式相关的危险因素方面未发现重大差异。在对年龄、吸烟、体重指数和性别进行多变量调整后，三项研究中与早发性死亡家族史阳性相关的心电图缺血的比值比（及95%置信区间[CI]）分别为1.42（1.10 - 1.82）、1.47（1.16 - 1.88）和1.37（0.78 - 2.41）。对收缩压、总胆固醇以及（若有）与生活方式相关的因素进行额外调整并未改变比值比的大小。总体而言，在45至64岁的男性中，有家族史阳性者心电图缺血明显更常见（多出36%）。
父母一方或双方因心脏相关疾病过早死亡的受试者心电图上缺血迹象更常见，且这与其他危险因素无关。
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