Impact of family history of coronary artery disease on in-hospital clinical outcomes in ST-segment myocardial infarction

Agarwal, Manyoo; Garg, Lohit; Lavie, Carl J.; Reed, Guy L.; Khouzam, Rami N.

doi:10.21037/atm.2017.09.27

Cited by 19 publications

(10 citation statements)

References 12 publications

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“…In contrast to our findings, this study identified FHpCVD in 54% of participants, which is probably due to different eligibility criteria. Our FHpCVD rate of 20.4% is closer to previous studies in patients with CVD [ 7 , 8 , 17 – 20 ] and in healthy subjects [ 1 , 21 ]. On the other hand, the prevalence of FHpCVD as a risk factor in patients with premature CVD has been estimated to be around 40% [ 22 ], which is obviously higher than the total (premature and non-premature combined) population.…”

Section: Discussionsupporting

confidence: 85%

“…In a comparable subgroup analysis to our study, they found that among both subgroups with or without previous MI or revascularization, FHpCVD was associated with lower all-cause mortality; neverthelss, this association was weaker within the subgroup who had prior MI or revascularization. Studies among patients with ACS and MI, although heterogenous in their population, definition of FHpCVD, and outcomes, have also reported the same paradoxical association between FHpCVD and better prognosis [ 8 , 17 , 18 , 20 ].…”

Section: Discussionmentioning

confidence: 99%

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Prognostic significance of positive family history in outcomes after coronary artery bypass grafting: Do we need to update our assumptions?

Tavolinejad

Rashedi

Ghorashi

et al. 2022

J Cardiothorac Surg

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Background Recent research suggests a protective role for positive family history of premature cardiovascular disease (FHpCVD) in patients undergoing coronary artery bypass grafting. We aimed to further investigate this unlikely association. Methods In this registry-based cohort study, patients who underwent first-time non-emergent coronary bypass surgery at Tehran Heart Center between 2007 and 2016 were included. Patients with and without FHpCVD were compared in terms of all-cause mortality and first non-fatal cardiovascular events (CVEs) comprising non-fatal acute coronary syndrome, non-fatal stroke or transient ischemic attack, and repeat coronary revascularization. Results A total of 13,156 patients were included (mean age 60.83 ± 9.57, 74.5% male), among which 2684 (20.4%) patients had FHpCVD. Median follow-up was 77.7 months. FHpCVD was weakly associated with reduced all-cause mortality using inverse probability weight (IPW) method (hazard ratio [HR] = 0.853; 95% confidence interval [CI] 0.730–0.997; P = 0.046), and not associated with non-fatal CVEs considering death as the competing event (sub-distribution HR [SHR] = 1.124; 95% CI 0.999–1.265; P = 0.053). Within a subgroup of patients without previous myocardial infarction or revascularization (7403 cases; 56.3%), FHpCVD was associated with lower mortality (HR = 0.700; 95% CI 0.548–0.894; P = 0.004) and higher non-fatal CVEs (SHR = 1.197; 95% CI 1.019–1.405; P = 0.028), whereas among patients with previous coronary events, there was no association between FHpCVD and outcomes. Conclusions FHpCVD was associated with lower all-cause mortality but higher non-fatal CVEs, especially in those without prior coronary events. Such discordance calls for caution in assuming a protective role for FHpCVD. The prognostic significance of FHpCVD needs further evaluation among surgical patients.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Prognostic significance of positive family history in outcomes after coronary artery bypass grafting: Do we need to update our assumptions?

Tavolinejad

Rashedi

Ghorashi

et al. 2022

J Cardiothorac Surg

View full text Add to dashboard Cite

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“…Coronary artery disease (CAD) is one of the leading causes of morbidity and mortality worldwide (1). Despite tremendous progress in diagnosis and treatment, it remains an important public health issue.…”

Section: Introductionmentioning

confidence: 99%

Andrographolide protects against endothelial dysfunction and inflammatory response in rats with coronary heart disease by regulating PPAR and NF-κB signaling pathways

Shu¹,

Huang²,

Tian³

et al. 2020

Ann Palliat Med

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Background: Andrographolide (Andro) is an active compound extracted from Andrographis, which has protective anti-inflammatory effects. But, its pathological role in coronary heart disease (CHD) is unclear, the aim of this study is to investigate the therapeutic effect of Andro in CHD and explore its potential mechanism.Methods: Here, we established a mouse model of CHD, and rats were randomly divided into 5 groups (n=10): sham, Andro (50 mg/kg), CHD, CHD + Andro (10 mg/kg), and CHD + Andro (50 mg/kg). HE staining was employed to evaluate the pathological changes of myocardial injury cardiac injury. The serum levels of total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), highdensity lipoprotein cholesterol (HDL-C), nitric oxide (NO), TXA2, ET-1, and prostaglandin I2 (PGI2) were detected by ELISA assay. Myocardial inflammation and the interaction between Andro and PPAR-α/NF-κB axis was measured using western blot.Results: Compared with CHD groups, Andro preserved cardiac injury and decreased the levels of TC, TG, and LDL-C while increasing the level of HDL-C. In addition, Andro also reduced the levels of TNF-α, MCP-1, hs-CRP and IL-1β by shifting the macrophage phenotype and attenuated the endothelial dysfunction by increasing the serum levels of ET-1 and TAX2 and decreasing the levels of NO and PGI2 in mice. Furthermore, Andro impeded cardiac apoptosis and inhibited the activation of PPARα and NF-κB proteins.Conclusions: Andro may represent a medicinal approach for assessing and treating CHD.

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“…Similarly, Abdi-Ali et al [ 32 ] reported that in patients with proven coronary disease, positive family history was associated with a 23% relative risk reduction of all-cause mortality over 5.6 years. Two other studies conducted by Canto et al [ 37 ] and Agarwal et al [ 38 ] showed that in a large population of patients with acute myocardial infarction, positive family history is associated with lower in-hospital mortality.…”

Section: Discussionmentioning

confidence: 99%

Significance of preoperative left ventricular ejection fraction in 5-year outcome after isolated CABG

Fallahzadeh

Sheikhy

Ajam

et al. 2021

J Cardiothorac Surg

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Background Pre-operative ejection fraction (EF) and comorbidities affect post-op outcomes. We aimed to compare the mortality and adverse events of patients with different baseline EF and also to evaluate the distribution of comorbidities in each EF group. Methods A total of 20,937 patients who underwent isolated coronary artery bypass graft (CABG) surgery from January 2006 to December 2016 was included. Patients were divided into three groups based on their pre-operative left ventricular EF as follows; (1) Normal: EF ≥ 50%; (2) Mild to moderately reduced: 50% < EF ≤ 35%; and (3) Severely reduced: EF < 35%. The backward elimination method was considered for multivariate Cox-regression analysis to locate predictors of mortality and non-fatal cerebro-cardiovascular events (CCVEs). The median follow-up time was 5.61 [3.12–8.0] years. Results The mean age in the total population was 60.94 ± 9.51 years and 73.6% of the total population was male. Diabetes mellitus was the common risk factor of mortality and CCVE in all EF groups. Impaired renal function (GFR < 60 ml/min) was associated with a higher risk of mortality after CABG regardless of EF level. The median 5-year mortality rate in patients with normal EF, mild-moderately reduced EF and severely reduced EF were 9.5%, 12.8%, and 22.7% respectively (P < 0.001). Although the trend of CCVEs was higher in severe left ventricle (LV) dysfunction, it was not statistically significant (p = 0.071). Conclusion Patients with severely reduced EF are at higher risk of mortality after CABG compared to those with higher EF levels; however, the rate of CCVEs may not be necessarily higher after adjustment for multiple pre-operative comorbidities.

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Impact of family history of coronary artery disease on in-hospital clinical outcomes in ST-segment myocardial infarction

Cited by 19 publications

References 12 publications

Prognostic significance of positive family history in outcomes after coronary artery bypass grafting: Do we need to update our assumptions?

Prognostic significance of positive family history in outcomes after coronary artery bypass grafting: Do we need to update our assumptions?

Andrographolide protects against endothelial dysfunction and inflammatory response in rats with coronary heart disease by regulating PPAR and NF-κB signaling pathways

Significance of preoperative left ventricular ejection fraction in 5-year outcome after isolated CABG

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