Familial clustering of myocardial infarction in first-degree relatives: a nationwide study

Nielsen, Mette; Andersson, Charlotte; Gerds, Thomas Alexander; Andersen, Per Kragh; Jensen, Thomas Bo; Køber, Lars; Gislason, Gunnar; Torp‐Pedersen, Christian

doi:10.1093/eurheartj/ehs475

Cited by 61 publications

(54 citation statements)

References 13 publications

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“…25,26 Existing research is however based on the associated risk in populations with a higher mean age and thus older parents, and our population might be too young to demonstrate any such association.…”

Section: Discussionmentioning

confidence: 89%

Prepregnancy Obesity and Associations With Stroke and Myocardial Infarction in Women in the Years After Childbirth

et al. 2014

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A disturbingly low rate of temporal decline in coronary heart disease mortality has been observed among women aged 35-44 years, compared with men and older women. 1 Additionally, women aged <45 years have an adverse prognosis after myocardial infarction as compared with men and older women, 2 and women 31-50 years old have a poorer prognosis than men after ischemic stroke.3 Further insight into cardiovascular risk factors and the prognosis of cardiovascular disease in young women is warranted, as requested by leading healthcare organizations including the American Heart Association. Clinical Perspective on p 337The World Health Organization states obesity to be the fifth leading cause of global death, 5 and the consequences of obesity has been found to have a higher impact in younger women (≤65 years of age) than in older women. 6 A recent report from the American Heart Association has furthermore documented that the rise in prevalent obesity is alarmingly rapid in the young.7 Despite the rising concerns regarding the obesity epidemic and the identification of young women as an overlooked group with a high morbidity after cardiovascular events, the association between obesity and the risk of cardiovascular disease in the young women has yet to be determined.We examined the associations between prepregnancy body mass index (BMI) and the risk of stroke and myocardial infarction in young, healthy women who have given birth in a nationwide study including pregnancy-associated risk factors in addition to well-established cardiovascular risk factors.Background-Cardiovascular events (stroke or myocardial infarction) are often associated with poorer prognosis in younger, compared with older individuals. We examined the associations between prepregnancy obesity and the risks of myocardial infarction and stroke in young, healthy women. ). The hazard ratios of myocardial infarction, ischemic stroke, and a composite outcome (myocardial infarction, stroke, cardiovascular death) were assessed using multivariable Cox regression models. We included 273 101 women with a median age of 30.4 years (interquartile range, 27.2-33.8). A total of 68 women experienced a myocardial infarction, and 175 women experienced an ischemic stroke. The adjusted hazard ratios of myocardial infarction compared with normal weight were 2.50 (95% confidence interval [95% CI], 0.97-6.50) in underweight, 1.68 (95% CI, 0.92-3.06) in overweight, and 2.63 (95% CI, 1.41-4.91) in obese women. For ischemic stroke the adjusted hazard ratios were 1.06 (95% CI, 0.44-2.28) in underweight, 1.27 (95% CI, 0.87-1.85) in overweight, and 1.89 (95% CI, 1.25-2.84) in obese women, respectively. For the composite outcome, hazard ratios were 1.34 (95% CI, 0.81-2.20), 1.43 (95% CI, 1.11-1.84), and 1.76 (95% CI, 1.31-2.34) for underweight, overweight, and obese women. Conclusions-In apparently healthy women of fertile age, prepregnancy obesity was associated with increased risks of ischemic stroke and myocardial infarction in the years after childbirth. (Circulation. 2014;129:...

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Section: Discussionmentioning

confidence: 89%

Prepregnancy Obesity and Associations With Stroke and Myocardial Infarction in Women in the Years After Childbirth

et al. 2014

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“…In a recently published study, common causative factors, including genetic thrombophilia and procoagulant markers, explained the increased risk of arterial cardiovascular disease after VTE. 27 A family history of MI has been shown to be associated with both arterial thrombotic disease 28,29 and VTE, 30,31 which suggests a common genetic component for both diseases. Concordantly, some inherited thrombophilias have also been associated with arterial thrombosis.…”

Section: Discussionmentioning

confidence: 99%

Impact of Incident Venous Thromboembolism on Risk of Arterial Thrombotic Diseases

et al. 2014

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Background-Growing evidence supports an association between venous thromboembolism (VTE) and arterial thrombotic diseases (ie, myocardial infarction and ischemic stroke). We aimed to study the association between VTE and future arterial events and to determine the population attributable risk of arterial events by VTE in a large prospective cohort recruited from the general population. Methods and Results-In 1994 to 1995 and 1993 to 1997, 81 687 subjects were included in the Tromsø Study and in the Diet, Cancer and Health Study and followed up to the date of incident venous and arterial events (myocardial infarction or ischemic stroke), death or migration, or to the end of the study period (2010 and 2008, respectively). There were 1208 cases of VTE and 90 subsequent arterial events during a median follow-up of 12.2 years. An association between VTE and future arterial events was found in all women and men aged <65 years but not in men aged >65 years. Women <65 years old with VTE had 3.3-fold higher risk of arterial disease (adjusted hazard ratio, 3.28; 95% confidence interval, 1.69-6.35) compared with women of the same age without VTE. The corresponding hazard ratio in men aged <65 years was 2.06 (95% confidence interval, 1.32-3.20). Only 0.9% of the arterial events were attributed to VTE, and the VTE explained 63.8% of the risk of arterial events among VTE patients. Conclusions-Our findings imply that women and young men with VTE have higher risk of arterial thrombotic disease than those without VTE. However, only 1% of the arterial thrombotic events in the population are attributed to VTE. (Circulation. 2014;129:855-863.)

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“…27 These findings were confirmed in a more recent study. 28 In most of these studies, the phenotype for CAD is a cardiovascular event, such as MI or death from cardiovascular causes.…”

Section: Heritability and Cadmentioning

confidence: 99%

Genetics of Coronary Artery Disease

Roberts

2014

Circulation Research

101

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Abstract:There is almost no data on the genetics of acute coronary syndromes, so this review discusses primarily the 50 genetic risk variants associated with coronary artery disease that are of genome-wide significance in the discovery population and replicated in an independent population. All of these risk variants are extremely common with more than half occurring in >50% of the general population. They increased only minimally the relative risk for coronary artery disease. The most striking finding is that 35 of the 50 risk variants act independently of known risk factors, indicating there are several pathways yet to be appreciated, contributing to the pathogenesis of coronary atherosclerosis and myocardial infarction. All of the genetic variants seem to act through atherosclerosis, except for the ABO blood groups, which show that A and B are associated with increased risk for myocardial infarction, mediated by a prolonged von Willebrand plasma half life leading to thrombosis. The potential molecular mechanisms of 9p21 are discussed, including cell cycle kinase inhibitors. Discovery of risk variants associated with PCSK9 has led to the development of novel treatment for plasma low-density lipoprotein cholesterol. A monoclonal antibody inhibiting PCSK9 has already undergone phase I and II clinical trials, showing it is a potent inhibitor of low-density lipoprotein cholesterol and is mediated through more rapid removal of low-density lipoprotein cholesterol from the plasma. This therapy complements that of statin therapy, which inhibits the synthesis of cholesterol. The benefits of Mendelian randomization to assess safety and efficacy and their limitations are discussed along with future directions.

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Familial clustering of myocardial infarction in first-degree relatives: a nationwide study

Cited by 61 publications

References 13 publications

Prepregnancy Obesity and Associations With Stroke and Myocardial Infarction in Women in the Years After Childbirth

Prepregnancy Obesity and Associations With Stroke and Myocardial Infarction in Women in the Years After Childbirth

Impact of Incident Venous Thromboembolism on Risk of Arterial Thrombotic Diseases

Genetics of Coronary Artery Disease

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