Department of Vascular Medicine, Academic Medical Centre, Amsterdam, The Netherlands.
Heart. 2012 Mar;98(6):490-4. doi: 10.1136/heartjnl-2011-300999. Epub 2011 Dec 22.
A positive family history of premature coronary artery disease (CAD) is a risk factor for cardiovascular disease (CVD), independent of traditional risk factors. Therefore, currently used risk algorithms poorly predict risk in these individuals. Novel methods are thus needed to assess cardiovascular risk. Pulse-wave velocity (PWV) might be such a method, but it is unknown whether PWV is increased in first-degree relatives of patients with premature CAD.
Observational case-control study.
Academic hospital.
Patients with premature CAD and a positive family history of premature CVD (n=50), their first-degree relatives without CVD (n=50) and unrelated controls (n=50).
None.
PWV was measured with using an Arteriograph system. Differences in PWV were assessed by a generalised linear model and multinomial logistic regression.
Patients with premature CAD had a higher PWV compared with first-degree relatives and controls (9.69±2.90 m/s vs 8.15±1.96 m/s and 7.38±1.08 m/s; p<0.05 patients vs all groups). Linear regression showed all groups related to PWV, with patients having the highest PWV and controls the lowest (p<0.0001). Furthermore, PWV was associated with first-degree relatives (OR 1.32, 95% CI 1.02 to 1.72; p<0.05) and premature CAD (OR 1.72, 95% CI 1.32 to 2.24; p<0.05) compared with controls. These findings were independent of blood pressure and other traditional risk factors.
Patients with premature CAD and their first-degree relatives had higher PWV compared with controls, independent of other risk factors. This holds promise for the future, in which arterial stiffness might play a role in risk prediction within families with premature CAD.
早发冠心病（CAD）阳性家族史是心血管疾病（CVD）的一个危险因素，独立于传统危险因素。因此，目前使用的风险算法在这些个体中对风险的预测效果不佳。因此，需要新的方法来评估心血管风险。脉搏波速度（PWV）可能是一种方法，但尚不清楚早发 CAD 患者的一级亲属的 PWV 是否会增加。
观察性病例对照研究。
学术医院。
早发 CAD 患者且有早发 CVD 阳性家族史（n=50）、无 CVD 的一级亲属（n=50）和无亲缘关系的对照（n=50）。
无。
使用 Arteriograph 系统测量 PWV。使用广义线性模型和多项逻辑回归评估 PWV 的差异。
与一级亲属和对照组相比，早发 CAD 患者的 PWV 更高（9.69±2.90 m/s 比 8.15±1.96 m/s 和 7.38±1.08 m/s；p<0.05 患者与所有组）。线性回归显示，各组与 PWV 相关，其中患者的 PWV 最高，对照组的 PWV 最低（p<0.0001）。此外，与对照组相比，PWV 与一级亲属（OR 1.32，95%CI 1.02 至 1.72；p<0.05）和早发 CAD（OR 1.72，95%CI 1.32 至 2.24；p<0.05）相关。这些发现独立于血压和其他传统危险因素。
与对照组相比，早发 CAD 患者及其一级亲属的 PWV 更高，独立于其他危险因素。这为未来提供了希望，即在早发 CAD 的家族中，动脉僵硬可能在风险预测中发挥作用。
