Article

Arterial abnormalities in the offspring of patients with premature myocardial infarction.

Division of Cardiology, A. Cardarelli Hospital, Naples, Italy.
New England Journal of Medicine (Impact Factor: 54.42). 10/2000; 343(12):840-6. DOI: 10.1056/NEJM200009213431203
Source: PubMed

ABSTRACT Findings from epidemiologic and autopsy studies suggest that the offspring of patients with premature coronary disease may be at increased risk for atherosclerosis. We undertook a study to determine whether changes in brachial-artery reactivity and thickness of the carotid intima and media, two markers of early atherosclerosis, are present in adolescents and young adults with a parental history of premature myocardial infarction.
We enrolled 40 healthy young people whose parents had had premature myocardial infarction (48 percent male; mean [+/-SD] age, 19.0+/-5.2 years) and 40 control subjects who were matched with the first group according to age and sex. All the subjects underwent high-resolution B-mode ultrasound examinations for the measurement of the brachial-artery vasodilatory response after arterial occlusion (i.e., reactive hyperemia) and the intima-media thickness of the distal common carotid arteries. Lipid profiles, blood pressure while at rest, body-mass index, and smoking status were also determined.
As compared with the control subjects, the offspring of patients with premature myocardial infarction had lower flow-mediated reactivity of the brachial arteries (5.7+/-5.0 percent, vs. 10.2+/-6.6 percent in the control subjects; P=0.001) and greater mean intima-media thickness of the common carotid artery (0.49+/-0.08 mm, vs. 0.44+/-0.07 mm in the control subjects, P=0.004). In the subjects with a parental history of premature myocardial infarction, an inverse association was found between brachial-artery reactivity and carotid intima-media thickness (r=-0.46, P=0.003). In a conditional logistic-regression analysis, both brachial-artery reactivity and carotid intima-media thickness were significantly and independently correlated with a parental history of premature myocardial infarction.
Structural and functional changes are present at an early age in the arteries of persons with a parental history of premature myocardial infarction.

0 Bookmarks
 · 
74 Views
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Flow mediated dilatation is a tool widely used to measure arterial responsiveness to sheer stress. However, there is scant literature to show how the peripheral arterial response changes as the vascular system mature. One reason for this is that the feasibility of measuring flow mediated dilatation in younger children has not been established. The aim of this study was to assess brachial artery function at rest and during flow mediated dilatation response after 4 minutes of ischemia of the forearm in children aged 6-15 years. Time to reach flow mediated dilatation maximum was found to correlate with age (r = 0.4, p < 0.05), resting brachial artery diameter (r = 0.4, p < 0.05), height (r = 0.4, p < 0.05), BMI (r = 0.45, p < 0.05), body surface area (r = 0.44, p < 0.05) and resting blood flow (r = 0.37, p < 0.05). However, no correlation between the traditional flow mediated dilatation response at 60s and for flow mediated dilatation maximal dilation was evident with age, resting brachial artery diameter, height, weight, BMI, body surface area, resting blood flow.In conclusion, the time taken to reach maximal dilation response is related to age and brachial artery luminal diameter and body habitus but not the traditional measures: FMD response at 60s or the maximal dilatation percentage.This article is protected by copyright. All rights reserved.
    Clinical and Experimental Pharmacology and Physiology 12/2014; · 2.41 Impact Factor
  • International Journal of Cardiology 11/2014; 180C:40-41. · 6.18 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Acute myocardial infarction (AMI) is often present in old populations and rare in young people. Its incidence significantly increased recent years. The mechanism and disease course of AMI in young people are probably different from that in old population. The aim of this study was to analyze clinical risk factors of STEMI in young patients. Data was collected from consecutive patients <= 44 years of age (young; n = 86) and 60-74 years of age (old; n = 65) diagnosed with STEMI, and 79 young age-matched patients without coronary artery disease (CAD), hospitalized between January 2009 and June 2013. The young STEMI group had a significantly higher proportion of males (88.37 vs. 53.16%; P < 0.01), smokers (82.56 vs. 49.37%; P < 0.01) and patients with a family history of early CAD (54.65 vs. 32.91%; P < 0.05) than age-matched controls. Young STEMI patients also had significantly higher levels of fasting blood sugar (6.39 vs. 5.25 mmol/L; P < 0.001), glycated hemoglobin (HbA1c) (6.26 vs. 5.45%; P < 0.05), total cholesterol (5.14 vs. 4.65 mmol/L, P < 0.05), and fibrinogen (Fib) (3.39 vs. 2.87; P < 0.01). Compared with the old STEMI group, young STEMI patients had significantly higher proportions of males (88.37 vs. 63.08%; P < 0.01) smokers (82.56 vs. 41.54%; P < 0.01), and those with a family history of early CAD (54.65 vs. 18.46%; P < 0.01). Young STEMI patients also lower Fib (3.39 vs. 3.88 g/L; P < 0.01), less frequent occurrence of angina pectoris before STEMI (13.95 vs. 29.23%; P < 0.05) compared with the old STEMI group. Logistic regression analysis indicated that male sex (OR = 5.891), smoking (OR = 3.500), family history of early CAD (OR = 3.194), Fib (OR = 2.414) and HbA1c (OR = 1.515) are associated with STEMI in young patients. In addition to previously recognized risk factors (male sex, smoking and family history of early CAD), Fib and HbA1c are associated with STEMI in individuals <= 44 years of age without antecedent angina pectoris.
    BMC Cardiovascular Disorders 12/2014; 14(1):179. · 1.50 Impact Factor

Full-text

Download
37 Downloads
Available from
May 19, 2014