Families of patients with premature coronary heart disease: an obvious but neglected target for primary prevention

Chow, Clara K; Pell, Alastair C H; Walker, Andrew; O'Dowd, Caroline; Dominiczak, Anna F.; Pell, Jill P.

doi:10.1136/bmj.39253.577859.be

Cited by 51 publications

(38 citation statements)

References 45 publications

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“…Although lifestyle counseling in the clinical setting has not been very effective (27), a recent UK report suggests that the relatives of patients admitted to the hospital for early MI constitute a group of people who may be at risk and who may be particularly motivated to make behavioral changes (18). Through modeling, the authors concluded that for every 14 patients admitted with premature MI, one additional premature MI could be avoided within 5 years among their siblings.…”

Section: Tailored Interventionsmentioning

confidence: 99%

Family History in Public Health Practice: A Genomic Tool for Disease Prevention and Health Promotion

Valdéz

Yoon

Qureshi

et al. 2010

Annu. Rev. Public Health

280

170

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Family history is a risk factor for many chronic diseases, including cancer, cardiovascular disease, and diabetes. Professional guidelines usually include family history to assess health risk, initiate interventions, and motivate behavioral changes. The advantages of family history over other genomic tools include a lower cost, greater acceptability, and a reflection of shared genetic and environmental factors. However, the utility of family history in public health has been poorly explored. To establish family history as a public health tool, it needs to be evaluated within the ACCE framework (analytical validity; clinical validity; clinical utility; and ethical, legal, and social issues). Currently, private and public organizations are developing tools to collect standardized family histories of many diseases. Their goal is to create family history tools that have decision support capabilities and are compatible with electronic health records. These advances will help realize the potential of family history as a public health tool.

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Section: Tailored Interventionsmentioning

confidence: 99%

Family History in Public Health Practice: A Genomic Tool for Disease Prevention and Health Promotion

Valdéz

Yoon

Qureshi

et al. 2010

Annu. Rev. Public Health

280

170

View full text Add to dashboard Cite

show abstract

“…Despite successive recommendations for screening of firstdegree relatives of patients with premature CHD, [13][14][15][16] the EUROASPIRE II study found that only 11% of siblings and 6% of children of such patients were screened in routine practice. 17 Several risk-prediction tools incorporate family history of MI, including the PROCAM, QRISK, and ASSIGN scores, although definitions are variable.…”

Section: Clinical Perspective See P 105mentioning

confidence: 99%

Sex-Specific Familial Clustering of Myocardial Infarction in Patients With Acute Coronary Syndromes

Banerjee

Silver

Heneghan

et al. 2009

Circ Cardiovasc Genet

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Background-Family history of premature myocardial infarction (MI) in first-degree relatives is a risk factor for MI and an indication for primary prevention. Although excess mother-to-daughter "transmission" occurs in ischemic stroke, no published studies have considered sex-of-parent/sex-of-proband interactions in the heritability of MI. Methods and Results-In a population-based study (Oxford Vascular Study) of all patients with acute coronary syndromes (ACS), irrespective of age, family history of all acute vascular events and related risk factors were analyzed by sex and age of both probands and first-degree relatives. Premature events were categorized as occurring at age Ͻ65 years. Of 835 probands with 1 or more ACS, 623 (420 men) had incident events and complete family history data. In probands with premature ACS, maternal history of both MI and of all vascular events were more common in female than male probands (odds ratio Greater emphasis should be placed on maternal than paternal history of MI, particularly in women aged Ͻ65 years.

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“…Despite the evidence from lifetime risk estimates 36 and Mendelian randomization studies 37,38 stressing the importance of risk factor control early in life, many young genetically predisposed individuals have a high prevalence of poorly controlled risk factors and are frequently missed as candidates for cardiovascular prevention because of low 10-year risk estimates. [39][40][41] A recent report suggests that individuals with a high GRS derive greater relative risk reductions from statin therapy than those with a low GRS. 42 Therefore, given the rapid progression of atherosclerosis seen in young patients with a high GRS (especially in those who also have a FHx), the overall clinical benefit of initiating statins in young genetically predisposed individuals may be favorable.…”

mentioning

confidence: 99%

Association Between Family History, a Genetic Risk Score, and Severity of Coronary Artery Disease in Patients With Premature Acute Coronary Syndromes

Hindieh

Pilote

Cheema

et al. 2016

ATVB

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Objective-A genetic risk score (GRS) for coronary artery disease has recently been shown to be independent of family history (FHx) in predicting future cardiovascular events. We sought to determine whether the presence of these risk factors, either individually or together, was associated with a higher burden of angiographic coronary artery disease. Approach and Results-We included 763 patients with premature acute coronary syndrome (median age, 50 [46-53] years; 30.8% women) with at least 1 major epicardial vessel stenosis enrolled in the Gender and Sex Determinants of Cardiovascular Disease From Bench to Beyond in Premature Acute Coronary Syndrome (GENESIS-PRAXY) study, a multicentre prospective cohort study of premature patients with acute coronary syndrome (aged ≤55 years). Key Words: acute coronary syndrome ◼ atherosclerosis ◼ cohort studies ◼ coronary heart disease ◼ genetics ◼ myocardial infarction

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Families of patients with premature coronary heart disease: an obvious but neglected target for primary prevention

Abstract: Risk of premature coronary heart disease is increased in the families of affected patients. C K Chow and colleagues argue that targeting relatives for primary prevention would be an effective policy

Cited by 51 publications

References 45 publications

Family History in Public Health Practice: A Genomic Tool for Disease Prevention and Health Promotion

Family History in Public Health Practice: A Genomic Tool for Disease Prevention and Health Promotion

Sex-Specific Familial Clustering of Myocardial Infarction in Patients With Acute Coronary Syndromes

Association Between Family History, a Genetic Risk Score, and Severity of Coronary Artery Disease in Patients With Premature Acute Coronary Syndromes

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