There is little data on the prevalence of coronary heart disease (CHD) in the young. The study aimed to estimate the prevalence of asymptomatic CHD in siblings of young patients with myocardial infarction (MI) using coronary computed tomography angiography (CCTA).
Prospective observational data was collected on siblings of patients aged ≤55 years presenting with acute MI and having coronary stenosis ≥50% on invasive coronary angiography in at least one epicardial coronary artery. Inclusion criteria included ages 30–55 and 30–60 years for males and females respectively. Outcome of interest was obstructive CHD by coronary computer tomography angiography (CCTA), which was defined by either moderate (50–69% stenosis) and/or severe (≥70% stenosis).
Fifty participants were studied of whom 20 (40%) were male. Thirty (60%) were current or ex-smokers, 4 (8%) had diabetes, 8 (16%) had hypertension and 26 (52%) had dyslipidaemia. Obstructive CHD by CCTA was detected in 9 (18%, 95% CI 9%–31%) participants and 3 (6%, 95% CI 1%–17%) participants were found to have severe luminal stenosis. The median radiation dose was 3.9 (IQR 0.9) mSv.
Approximately a fifth of siblings of young MI patients were found to have asymptomatic but obstructive CHD detected on CCTA of which one third was severe. This is a group in whom screening for CHD warrants further investigation.
Abbreviations:ACE (angiotensin converting enzyme), ARB (angiotensin II receptor blocker), BMI (body mass index), CABG (coronary artery bypass grafting), CCTA (coronary computer tomography angiography), CHD (coronary heart disease), CI (confidence interval), CVA (cerebrovascular accident), HDL (high-density lipoprotein), HU (Hounsfield unit), LDL (low-density lipoprotein), LMCA (left main coronary artery), MI (myocardial infarction), mSv (millisievert), NSTEMI (non ST-elevation myocardial infarction), OR (odds ratio), PCI (percutaneous coronary intervention), PVD (peripheral vascular disease), SE (stress echocardiography), STEMI (ST-elevation myocardial infarction)
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Published online: April 26, 2017
Accepted: March 16, 2017
Received in revised form: January 16, 2017
Received: August 3, 2016
© 2017 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.