Preisler Yoav, Ziv-Baran Tomer, Chorin Ehud, Margolis Gilad, Khoury Shafik, Shacham Yacov
Sackler Faculty of Medicine.
Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine.
Coron Artery Dis. 2018 Dec;29(8):657-662. doi: 10.1097/MCA.0000000000000667.
A positive family history (FHx+) of coronary artery disease (CAD) is a well-known risk factor for the development of coronary pathology in first-degree relatives. We sought to evaluate the association between FHx+ of CAD and clinical outcomes in patients presenting with a first ST-elevation myocardial infarction (STEMI).
A historical cohort study of all patients with a first STEMI, who were admitted to cardiac ICU between 2007 and 2016, was carried out. Univariate and multivariate analyses were carried out to compare patients with or without a FHx+ of CAD. In further analysis, propensity score matching was used to reduce differences in baseline characteristics.
The study included 1785 patients, 365 (20%) of whom had FHx+ of CAD. FHx+ was associated with decreased in-hospital major adverse events and long-term mortality rates (hazard ratio=0.208, 95% confidence interval: 0.051-0.857; P=0.03). After propensity score matching, patients with FHx+ had decreased long-term mortality rates (hazard ratio=0.105, 95% confidence interval: 0.033-0.33; P<0.001).
In this large cohort of patients with STEMI, FHx+ was associated with better short-term and long-term outcomes. Understanding the rule of FHx in patients with STEMI is important to evaluate the prognosis and may help to construct a prediction model for patients admitted to cardiac ICU.
冠心病（CAD）的阳性家族史（FHx+）是一级亲属发生冠状动脉病变的一个众所周知的危险因素。我们试图评估CAD的FHx+与首次ST段抬高型心肌梗死（STEMI）患者临床结局之间的关联。
对2007年至2016年间入住心脏重症监护病房的所有首次发生STEMI的患者进行了一项历史性队列研究。进行单因素和多因素分析以比较有无CAD的FHx+的患者。在进一步分析中，采用倾向评分匹配来减少基线特征的差异。
该研究纳入了1785例患者，其中365例（20%）有CAD的FHx+。FHx+与住院期间主要不良事件减少和长期死亡率降低相关（风险比=0.208，95%置信区间：0.051-0.857；P=0.03）。倾向评分匹配后，有FHx+的患者长期死亡率降低（风险比=0.105，95%置信区间：0.033-0.33；P<0.001）。
在这个大型STEMI患者队列中，FHx+与较好的短期和长期结局相关。了解FHx在STEMI患者中的规律对于评估预后很重要，并且可能有助于构建入住心脏重症监护病房患者的预测模型。
