Centre for Health and Society, Institute for Medical Sociology, University Clinic Düsseldorf, University of Düsseldorf, Düsseldorf, Germany.
Eur J Epidemiol. 2013 Apr;28(4):301-10. doi: 10.1007/s10654-012-9743-1. Epub 2012 Nov 4.
A parental history of premature coronary heart disease (CHD) is an established risk factor for CHD events in descendants. The study aim was to investigate whether subclinical coronary artery calcification (CAC) differs between asymptomatic individuals (a) without a parental CHD history, (b) with a parental history and (c) without knowledge of parental CHD history. The inclusion of individuals without knowledge of parental CHD history is a new approach. We also differentiated between CHD of mother and father to gain insight into their individual contributions. Data was obtained for 4,301 subjects aged 45-75 years free of overt CHD from the baseline screening of the population-based Heinz Nixdorf Recall study. CAC, measured by electron-beam computed tomography, was modeled conducting logistic regressions. Model 1 included family history, Model 2 was adjusted for age (and gender) and Model 3 added common CHD risk factors. The CAC score was dichotomized using the age and sex-specific 75th percentile. The odds ratio (OR) for CAC ≥ age and sex-specific 75th percentile was 1.33 among individuals with parental premature CHD history (95 % confidence interval [95 %CI]: 1.08, 1.63), which did not change after full adjustment (OR 1.40, 95 %CI: 1.13, 1.74). Individuals with an unknown biological father or mother had a high chance of elevated CAC scores (fully adjusted; father: OR 1.38, 95 %CI: 1.01, 1.90, mother: OR 1.86, 95 %CI: 0.90, 3.84) compared to the reference group. The current study showed an association between parental CHD history and CAC independent of common CHD risk factors. This association affirms the use of parental CHD history in cardiovascular risk assessment among asymptomatic adults in routine practice. The observation that individuals who did not know their mother or father are prone to increased CAC scores needs further confirmation in large scale studies.
父母中一方有早发性冠心病（CHD）病史是后代发生 CHD 事件的既定危险因素。本研究旨在探讨无症状个体（a）无父母 CHD 病史、（b）有父母 CHD 病史和（c）不知父母 CHD 病史时，亚临床冠状动脉钙化（CAC）是否存在差异。纳入不知父母 CHD 病史的个体是一种新方法。我们还区分了母亲和父亲的 CHD，以深入了解他们各自的贡献。该研究的数据来自人群为基础的 Heinz Nixdorf 回顾研究的基线筛查，共纳入了 4301 名年龄在 45-75 岁之间、无明显 CHD 的个体。通过电子束计算机断层扫描（EBCT）测量 CAC，并采用逻辑回归模型进行建模。模型 1 纳入家族史，模型 2 调整年龄（和性别），模型 3 加入常见 CHD 危险因素。使用年龄和性别特异性第 75 百分位数将 CAC 评分分为二分类。有父母早发性 CHD 病史者的 CAC≥年龄和性别特异性第 75 百分位数的比值比（OR）为 1.33（95%置信区间[95%CI]：1.08，1.63），经充分调整后未发生变化（OR 1.40，95%CI：1.13，1.74）。与参考组相比，不知道生父或生母的个体 CAC 评分升高的可能性较大（完全调整后；父亲：OR 1.38，95%CI：1.01，1.90，母亲：OR 1.86，95%CI：0.90，3.84）。本研究显示，在无症状成年人中，父母 CHD 病史与 CAC 独立于常见 CHD 危险因素相关。该关联证实了在常规实践中，可将父母 CHD 病史用于无症状成年人的心血管风险评估。需要在大规模研究中进一步证实不知道母亲或父亲的个体 CAC 评分升高的观察结果。
