Arterial abnormalities in the offspring of patients with premature myocardial infarction

University of Naples Federico II, Napoli, Campania, 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.

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Available from: Giovanni Gaeta, Dec 13, 2013
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    • "Intimal thickening of the coronary arteries in infancy, determined in autopsy studies, has been shown to be associated with the grandparents' history of coronary disease [14]. Angiographic [15] [16] [17] and ultrasonic [18] [19] [20] studies of atherosclerosis show that patients with a familial aggregation of CHD have more advanced atherosclerosis than appropriate controls. Although a family history of CHD has long been recognized as a major risk factor for atherosclerosis, the possible protective effect of genetic factors or specific family behaviours in a family with long-lived members has not been investigated before. "
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    • "The study protocol was approved by the local committee on ethical practice and written informed consent was obtained from each subject and/or their parents. Fifteen of the 54 children–adolescents (28%) and 25 (42%) of the 60 young adults were included in our previous report [10] . All participants were administered a standardized questionnaire to obtain information about current smoking, history of diabetes and hypertension, and family history of coronary artery disease. "
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