Banerjee Amitava, Silver Louise E, Heneghan Carl, Welch Sarah J V, Bull Linda M, Mehta Ziyah, Banning Adrian P, Rothwell Peter M
Stroke Prevention Research Unit, University of Oxford, Oxford, United Kingdom.
Circ Cardiovasc Genet. 2009 Apr;2(2):98-105. doi: 10.1161/CIRCGENETICS.108.806562. Epub 2009 Feb 12.
Family history of premature myocardial infarction (MI) in first-degree relatives is a risk factor for MI and an indication for primary prevention. Although excess mother-to-daughter "transmission" occurs in ischemic stroke, no published studies have considered sex-of-parent/sex-of-proband interactions in the heritability of MI.
In a population-based study (Oxford Vascular Study) of all patients with acute coronary syndromes (ACS), irrespective of age, family history of all acute vascular events and related risk factors were analyzed by sex and age of both probands and first-degree relatives. Premature events were categorized as occurring at age <65 years. Of 835 probands with 1 or more ACS, 623 (420 men) had incident events and complete family history data. In probands with premature ACS, maternal history of both MI and of all vascular events were more common in female than male probands (odds ratio [OR], 2.25; 95% CI, 1.02 to 4.94; P=0.04 and OR, 3.03; 95% CI, 1.47 to 6.26; P=0.002, respectively). No such effect existed for paternal history (OR, 1.00; 95% CI, 0.46 to 2.10; P=0.99 and OR, 1.19; 95% CI, 0.58 to 2.43; P=0.63, respectively). Age at ACS in probands was highly correlated with age at MI in mothers (r=0.46, P<0.001), regardless of the proband's sex. Consequently, history of premature maternal MI was strongly associated with premature ACS and premature MI in female (OR, 10.52; 95% CI, 2.17 to 56.6; P=0.001 and OR, 7.31; 95% CI, 1.55 to 34.6; P=0.004, respectively) and male probands (OR, 3.88; 95% CI, 1.20 to 12.6; P=0.01 and OR, 3.63; 95% CI, 1.13 to 11.60; P=0.02, respectively).
Important sex-of-parent/sex-of-proband interactions exist in the family history of MI in patients with ACS. Greater emphasis should be placed on maternal than paternal history of MI, particularly in women aged <65 years.
一级亲属中有早发心肌梗死（MI）家族史是MI的一个危险因素，也是一级预防的指征。虽然在缺血性卒中中存在过多的母系向女儿的“传递”，但尚无已发表的研究考虑在MI遗传中亲代性别/先证者性别的相互作用。
在一项基于人群的研究（牛津血管研究）中，对所有急性冠状动脉综合征（ACS）患者，无论年龄大小，按先证者和一级亲属的性别及年龄分析所有急性血管事件的家族史和相关危险因素。早发事件定义为发生在年龄<65岁时。在835例有1次或更多次ACS的先证者中，623例（420例男性）有新发事件及完整的家族史数据。在先证者有早发ACS的情况下，母亲有MI病史和所有血管事件病史在女性先证者中比男性先证者更常见（优势比[OR]分别为2.25；95%可信区间[CI]为1.02至4.94；P=0.04和OR为3.03；95%CI为1.47至6.26；P=0.002）。父系病史则无此效应（OR分别为1.00；95%CI为0.46至2.10；P=0.99和OR为1.19；95%CI为0.58至2.43；P=0.63）。无论先证者性别如何，先证者发生ACS的年龄与母亲发生MI的年龄高度相关（r=0.46，P<0.001）。因此，母亲有早发MI病史与女性（OR分别为10.52；95%CI为2.17至56.6；P=0.001和OR为7.31；95%CI为1.55至34.6；P=0.004）和男性先证者（OR分别为3.88；95%CI为1.20至12.6；P=0.01和OR为3.63；95%CI为1.13至11.60；P=0.02）的早发ACS和早发MI密切相关。
在ACS患者的MI家族史中存在重要的亲代性别/先证者性别的相互作用。应更加强调母亲的MI病史而非父亲的MI病史，尤其是在年龄<65岁的女性中。
