Centre for Cardiovascular Sciences, University of Birmingham, United Kingdom.
Atherosclerosis. 2012 Apr;221(2):451-7. doi: 10.1016/j.atherosclerosis.2012.01.033. Epub 2012 Jan 30.
Family history of MI is an established risk factor for coronary artery disease and subclinical atherosclerosis. Maternal MI and maternal stroke are more common in females than males presenting with acute coronary syndromes (ACS), suggesting sex-specific heritability, but the effects of family history on location and extent of coronary artery disease are unknown.
In a prospective, population-based study (Oxford Vascular Study) of all patients with ACS, family history data for stroke and MI were analysed by sex of proband and affected first degree relatives (FDRs), and coronary angiograms were reviewed, where available.
Of 835 probands with one or more ACS, 623 (420 males) had incident events and complete family history data. 351 patients with incident events (56.3%; 266 males) underwent coronary angiography. Neither angiographic disease localization nor severity were associated with sex-of-parent/sex-of-offspring in men or women.
Sex-specific family history data do not predict angiographic localization of coronary disease in patients presenting with ACS. Maternal stroke and maternal MI probably affect ACS in females by a mechanism unrelated to atherosclerosis or coronary anatomy. However, family history data may still be useful in risk prediction and prognosis of ACS.
家族史 MI 是冠心病和亚临床动脉粥样硬化的既定危险因素。与急性冠脉综合征 (ACS) 相关的女性患者中，心肌梗死和中风的母亲发病率高于男性，这表明存在性别特异性遗传易感性，但家族史对冠状动脉疾病的位置和严重程度的影响尚不清楚。
在一项针对所有 ACS 患者的前瞻性、基于人群的研究（牛津血管研究）中，通过先证者和一级亲属（FDR）的性别分析中风和 MI 的家族史数据，并在有条件的情况下审查冠状动脉造影结果。
在 835 名患有 ACS 的先证者中，有 623 名（420 名男性）发生了事件，并且有完整的家族史数据。351 名发生事件的患者（56.3%，266 名男性）接受了冠状动脉造影检查。在男性或女性中，血管造影疾病定位或严重程度与父母性别/子女性别之间均无相关性。
特定性别的家族史数据不能预测 ACS 患者的冠状动脉疾病的血管造影定位。女性的中风和心肌梗死的母亲发病率较高可能与动脉粥样硬化或冠状动脉解剖无关的机制有关。然而，家族史数据在 ACS 的风险预测和预后方面仍可能有用。
